Defebvre L, Derambure P, Bourriez J L, Destée A, Guieu J D
Service de neurophysiologie clinique, CHRU de Lille, France.
Neurophysiol Clin. 1999 Feb;29(1):71-89. doi: 10.1016/s0987-7053(99)80042-2.
This study was aimed at determining the spatiotemporal distribution of event-related desynchronization (ERD) during self-paced voluntary movement in order to establish the interest of this method for the analysis of movement programming in Parkinson's disease. Desynchronization of mu rhythm was recorded 2 s before to 0.5 s after right then left self-paced voluntary wrist flexions from 11 leads covering the primary sensorimotor cortex (central), supplementary motor area (frontocentral) and parietal cortex (parietocentral). Recordings were obtained from ten control subjects, ten patients treated for Parkinson's disease (bilateral symptoms) and 20 patients presenting with right or left hemiparkinsonism before and after chronic administration of L-dopa. In the control group, ERD started over the contralateral primary sensorimotor cortex 1,750 ms before movement and was bilateral just before performance of the movement. In both treated and de novo Parkinson's disease groups, decrease in ERD latency (1,000 to 1,250 ms before movement) was only observed when movements were performed with the akinetic hand and corresponded to a decrease in motor cortical activity. This confirmed that programming of movement is affected in Parkinson's disease. Earlier ERD with central ipsilateral distribution were also observed, suggesting that other cortical areas might be activated to compensate for dysfunction of movement programming and to increase the level of cortical activity required for performance of the movement. The administration of L-dopa to de novo hemiparkinsonians patients resulted in increased ERD latency over contralateral and ipsilateral central areas. As in the treated Parkinson's disease group, frontocentral ERD could also be recorded. L-dopa would thus partially restore the affected motor programmation and modulate cortical activation in both supplementary motor area and primary motor cortex, the later receiving more afferences from basal ganglia.
本研究旨在确定自主节律性随意运动期间事件相关去同步化(ERD)的时空分布,以确立该方法在帕金森病运动编程分析中的价值。在覆盖初级感觉运动皮层(中央区)、辅助运动区(额中央区)和顶叶皮层(顶中央区)的11个导联上,记录了从右侧然后左侧自主节律性随意腕部屈曲前2秒至后0.5秒期间的μ节律去同步化情况。记录来自10名对照受试者、10名接受帕金森病治疗(双侧症状)的患者以及20名在长期服用左旋多巴前后出现右侧或左侧偏侧帕金森病的患者。在对照组中,ERD在运动前1750毫秒开始于对侧初级感觉运动皮层,并且在运动即将进行时变为双侧性。在治疗组和新发帕金森病组中,仅当用运动不能的手进行运动时才观察到ERD潜伏期缩短(运动前1000至1250毫秒),这与运动皮层活动的降低相对应。这证实了帕金森病中运动编程受到影响。还观察到早期的ERD具有中央同侧分布,这表明其他皮层区域可能被激活以补偿运动编程功能障碍并提高运动执行所需的皮层活动水平。对新发偏侧帕金森病患者给予左旋多巴导致对侧和同侧中央区的ERD潜伏期增加。与治疗的帕金森病组一样,也可以记录到额中央区的ERD。因此,左旋多巴将部分恢复受影响的运动编程,并调节辅助运动区和初级运动皮层中的皮层激活,后者从基底神经节接收更多传入信号。