帕金森病中的慢振荡活动与左旋多巴诱发的异动症
Slow oscillatory activity and levodopa-induced dyskinesias in Parkinson's disease.
作者信息
Alonso-Frech F, Zamarbide I, Alegre M, Rodríguez-Oroz M C, Guridi J, Manrique M, Valencia M, Artieda J, Obeso J A
机构信息
Department of Neurology and Neurosurgery, Neuroscience Area, Clinica Universitaria and Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra Pamplona, Spain.
出版信息
Brain. 2006 Jul;129(Pt 7):1748-57. doi: 10.1093/brain/awl103. Epub 2006 May 9.
The pathophysiology of levodopa-induced dyskinesias (LID) in Parkinson's disease is not well understood. We have recorded local field potentials (LFP) from macroelectrodes implanted in the subthalamic nucleus (STN) of 14 patients with Parkinson's disease following surgical treatment with deep brain stimulation. Patients were studied in the 'Off' medication state and in the 'On' motor state after administration of levodopa-carbidopa (po) or apomorphine (sc) that elicited dyskinesias in 11 patients. The logarithm of the power spectrum of the LFP in selected frequency bands (4-10, 11-30 and 60-80 Hz) was compared between the 'Off' and 'On' medication states. A peak in the 11-30 Hz band was recorded in the 'Off' medication state and reduced by 45.2% (P < 0.001) in the 'On' state. The 'On' was also associated with an increment of 77. 6% (P < 0.001) in the 4-10 Hz band in all patients who showed dyskinesias and of 17.8% (P < 0.001) in the 60-80 Hz band in the majority of patients. When dyskinesias were only present in one limb (n = 2), the 4-10 Hz peak was only recorded in the contralateral STN. These findings suggest that the 4-10 Hz oscillation is associated with the expression of LID in Parkinson's disease.
帕金森病中左旋多巴诱发异动症(LID)的病理生理学尚未完全明确。我们记录了14例接受脑深部电刺激手术治疗的帕金森病患者丘脑底核(STN)植入的宏观电极的局部场电位(LFP)。患者在未用药状态以及服用左旋多巴-卡比多巴(口服)或阿扑吗啡(皮下注射)后出现异动症的“开”运动状态下接受研究,11例患者出现了异动症。比较了选定频段(4 - 10、11 - 30和60 - 80赫兹)LFP功率谱的对数在未用药状态和“开”药状态之间的差异。在未用药状态下记录到11 - 30赫兹频段有一个峰值,在“开”药状态下降低了45.2%(P < 0.001)。在所有出现异动症的患者中,“开”药状态还与4 - 10赫兹频段增加77.6%(P < 0.001)以及大多数患者60 - 80赫兹频段增加17.8%(P < 0.001)相关。当异动症仅出现在一个肢体时(n = 2),4 - 10赫兹的峰值仅在对侧STN中记录到。这些发现表明4 - 10赫兹振荡与帕金森病中LID的表达相关。