Subthalamic stimulation modulates cortical motor network activity and synchronization in Parkinson's disease.
Subthalamic stimulation modulates cortical motor network activity and synchronization in Parkinson's disease.
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丘脑底刺激调节帕金森病的皮质运动网络活动和同步。
DOI：
10.1093/brain/awu380
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
A. Gharabaghi
中科院分区：
文献类型：
--
作者：
D. Weiss;R. Klotz;R. Govindan;M. Scholten;G. Naros;A. Ramos;F. Bunjes;C. Meisner;C. Plewnia;R. Krüger;A. Gharabaghi
大规模网络活动和同步的动态调节是广泛的认知过程所固有的，并且在包括帕金森病在内的神经精神疾病中受到干扰。在这里，我们着手解决运动网络活动和同步在帕金森氏病及其调制与丘脑底刺激。为此，20例特发性帕金森病患者丘脑底核刺激进行了分析，外部提示右手手指运动与1.5秒的刺激间隔。从拮抗肌（右趾屈肌和趾伸肌）的肌电图和64通道脑电图同时获得记录。时间-频率事件相关的频谱扰动进行了评估，以确定皮质和肌肉活动。其次，在时间-频率域的交叉谱分析，探索皮层-皮层同步。时频调制使我们能够选择与运动处理相关的时频范围。在这些时间-频率窗口，我们开发了一个扩展的相位同步指数量化的全球皮质-皮质同步，并获得地形分化的不同电极网站相对于其贡献的全球相位同步指数。使用回归分析，光谱测量用于预测临床和反应时间结果。我们发现，与双侧顶叶、感觉运动区、运动前区、运动辅助区和前额叶区（包括双侧下前额叶区）的电极上的"刺激开“与”刺激关“相比，在上α和β范围内的皮质活动的运动相关去极化显著促进。这些光谱调制使我们能够预测丘脑底核刺激的临床和反应时间改善。随着“刺激”，大脑半球间的皮质-皮质的连贯性在β带显着衰减的双边感觉运动区。同样，全球皮质-皮质相位同步衰减，地形分化显示更强的desperization（同侧）右半球前额叶，运动前区和感觉运动区相比，“刺激关闭”。我们进一步证明，皮质-皮质相位同步主要是由真正的神经元耦合。与“刺激关闭”相比，“刺激打开”的临床改善可以从这种皮质解耦与多元回归中预测，并且右前额叶区域的同步减少与临床改善呈线性单变量相关。我们的研究表明，广泛的活动和同步调制的皮层运动网络，并强调丘脑底核刺激作为一种网络调制疗法。因此，丘脑底核刺激可以通过促进运动相关的去极化来释放双侧皮质计算资源。此外，丘脑底核对于平衡运动程序中的抑制性和易化性皮质参与者至关重要。
Dynamic modulations of large-scale network activity and synchronization are inherent to a broad spectrum of cognitive processes and are disturbed in neuropsychiatric conditions including Parkinson's disease. Here, we set out to address the motor network activity and synchronization in Parkinson's disease and its modulation with subthalamic stimulation. To this end, 20 patients with idiopathic Parkinson's disease with subthalamic nucleus stimulation were analysed on externally cued right hand finger movements with 1.5-s interstimulus interval. Simultaneous recordings were obtained from electromyography on antagonistic muscles (right flexor digitorum and extensor digitorum) together with 64-channel electroencephalography. Time-frequency event-related spectral perturbations were assessed to determine cortical and muscular activity. Next, cross-spectra in the time-frequency domain were analysed to explore the cortico-cortical synchronization. The time-frequency modulations enabled us to select a time-frequency range relevant for motor processing. On these time-frequency windows, we developed an extension of the phase synchronization index to quantify the global cortico-cortical synchronization and to obtain topographic differentiations of distinct electrode sites with respect to their contributions to the global phase synchronization index. The spectral measures were used to predict clinical and reaction time outcome using regression analysis. We found that movement-related desynchronization of cortical activity in the upper alpha and beta range was significantly facilitated with 'stimulation on' compared to 'stimulation off' on electrodes over the bilateral parietal, sensorimotor, premotor, supplementary-motor, and prefrontal areas, including the bilateral inferior prefrontal areas. These spectral modulations enabled us to predict both clinical and reaction time improvement from subthalamic stimulation. With 'stimulation on', interhemispheric cortico-cortical coherence in the beta band was significantly attenuated over the bilateral sensorimotor areas. Similarly, the global cortico-cortical phase synchronization was attenuated, and the topographic differentiation revealed stronger desynchronization over the (ipsilateral) right-hemispheric prefrontal, premotor and sensorimotor areas compared to 'stimulation off'. We further demonstrated that the cortico-cortical phase synchronization was largely dominated by genuine neuronal coupling. The clinical improvement with 'stimulation on' compared to 'stimulation off' could be predicted from this cortical decoupling with multiple regressions, and the reduction of synchronization over the right prefrontal area showed a linear univariate correlation with clinical improvement. Our study demonstrates wide-spread activity and synchronization modulations of the cortical motor network, and highlights subthalamic stimulation as a network-modulating therapy. Accordingly, subthalamic stimulation may release bilateral cortical computational resources by facilitating movement-related desynchronization. Moreover, the subthalamic nucleus is critical to balance inhibitory and facilitatory cortical players within the motor program.
影响因子：
5.7
作者：
Herz, Damian M.;Siebner, Hartwig R.;Timmermann, Lars
通讯作者：
Timmermann, Lars