Fawcett Adrian P, Moro Elena, Lang Anthony E, Lozano Andres M, Hutchison William D
Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Mov Disord. 2005 Mar;20(3):371-7. doi: 10.1002/mds.20356.
Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is being evaluated as a potential new therapy for patients with Huntington's disease (HD). In addition to skeletal movement disorders, HD patients have difficulty initiating voluntary saccades and have difficulty in suppressing rapid saccades toward newly appearing stimuli. We measured several saccade parameters in an HD patient who had marked improvement of clinical symptoms with bilateral GPi DBS to determine whether oculomotor performance improved in parallel with clinical scores. Oculomotor performance was assessed using three testing paradigms: pro-saccades, anti-saccades, and memory-guided saccades. The data from the HD patient was also compared to that of two healthy controls. Pallidal DBS decreased pro-saccade latency, total movement time, and the number of correctly executed trials, as well as increasing saccade gain. Memory-saccade performance was negatively affected with stimulation: saccade gain decreased, latency increased, and the patient's ability to suppress unwanted saccades decreased with stimulation. Our data demonstrate a task-specific improvement of oculomotor deficits in this HD patient with pallidal DBS, supporting a role of GPi in oculomotor control.
内侧苍白球（GPi）的深部脑刺激（DBS）正在作为亨廷顿舞蹈症（HD）患者的一种潜在新疗法进行评估。除了骨骼运动障碍外，HD患者在启动自主扫视方面存在困难，并且难以抑制对新出现刺激的快速扫视。我们在一名通过双侧GPi DBS使临床症状显著改善的HD患者中测量了几个扫视参数，以确定眼球运动表现是否与临床评分同步改善。使用三种测试范式评估眼球运动表现：顺向扫视、逆向扫视和记忆引导扫视。还将该HD患者的数据与两名健康对照者的数据进行了比较。苍白球DBS缩短了顺向扫视潜伏期、总运动时间和正确执行试验的次数，同时增加了扫视增益。刺激对记忆扫视表现有负面影响：扫视增益降低，潜伏期延长，并且随着刺激，患者抑制不必要扫视的能力下降。我们的数据表明，在这名接受苍白球DBS的HD患者中，眼球运动缺陷有特定任务的改善，支持了GPi在眼球运动控制中的作用。
