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振荡性脑活动减慢是无痴呆帕金森病的一个稳定特征。

Slowing of oscillatory brain activity is a stable characteristic of Parkinson's disease without dementia.

作者信息

Stoffers D, Bosboom J L W, Deijen J B, Wolters E C, Berendse H W, Stam C J

机构信息

Institute for Clinical and Experimental Neurosciences, Department of Neurology, VU University Medical Center, P.O. box 7057, 1007 MB, Amsterdam, The Netherlands.

出版信息

Brain. 2007 Jul;130(Pt 7):1847-60. doi: 10.1093/brain/awm034. Epub 2007 Apr 5.

Abstract

Extensive changes in resting-state oscillatory brain activity have recently been demonstrated using magnetoencephalography (MEG) in moderately advanced, non-demented Parkinson's disease patients relative to age-matched controls. The aim of the present study was to determine the onset and evolution of these changes over the disease course and their relationship with clinical parameters. In addition, we evaluated the effects of dopaminomimetics on resting-state oscillatory brain activity in levodopa-treated patients. MEG background oscillatory activity was studied in a group of 70 Parkinson's disease patients with varying disease duration and severity (including 18 de novo patients) as well as in 21 controls that were age-matched to the de novo patients. Whole head 151-channel MEG recordings were obtained in an eyes-closed resting-state condition. Levodopa-treated patients (N = 37) were examined both in a practically defined 'OFF' as well as in the 'ON' state. Relative spectral power was calculated for delta, theta, low alpha, high alpha, beta and gamma frequency bands and averaged for 10 cortical regions of interest (ROIs). Additionally, extensive clinical and neuropsychological testing was performed in all subjects. De novo Parkinson's disease patients showed widespread slowing of background MEG activity relative to controls. Changes included a widespread increase in theta and low alpha power, as well as a loss of beta power over all but the frontal ROIs and a loss of gamma power over all but the right occipital ROI. Neuropsychological assessment revealed abnormal perseveration in de novo patients, which was associated with increased low alpha power in centroparietal ROIs. In the whole group of Parkinson's disease patients, longer disease duration was associated with reduced low alpha power in the right temporal and right occipital ROI, but not with any other spectral power measure. No association was found between spectral power and disease stage, disease severity or dose of dopaminomimetics. In patients on levodopa therapy, a change from the 'OFF' to the 'ON' state was associated with decreases in right frontal theta, left occipital beta and left temporal gamma power and an increase in right parietal gamma power. Widespread slowing of oscillatory brain activity is a characteristic of non-demented Parkinson's disease patients from the earliest clinical stages onwards that is (largely) independent of disease duration, stage and severity and hardly influenced by dopaminomimetic treatment. Some early cognitive deficits in Parkinson's disease appear to be associated with increased low alpha power. We postulate a role for hypofunctional non-dopaminergic ascending neurotransmitter systems in spectral power changes in non-demented Parkinson's disease patients.

摘要

最近通过脑磁图(MEG)已证实在中度进展期、非痴呆帕金森病患者中,相对于年龄匹配的对照组,静息态脑振荡活动存在广泛变化。本研究的目的是确定这些变化在疾病进程中的起始和演变情况及其与临床参数的关系。此外,我们评估了多巴胺模拟物对左旋多巴治疗患者静息态脑振荡活动的影响。对一组70例疾病持续时间和严重程度各异的帕金森病患者(包括18例初发患者)以及21例与初发患者年龄匹配的对照组进行了MEG背景振荡活动研究。在闭眼静息状态下获取全脑151通道MEG记录。对左旋多巴治疗的患者(N = 37)在实际定义的“关”状态以及“开”状态下均进行了检查。计算了δ、θ、低α、高α、β和γ频段的相对谱功率,并对10个感兴趣的皮质区域(ROI)进行了平均。此外,对所有受试者进行了广泛的临床和神经心理学测试。初发帕金森病患者相对于对照组显示出背景MEG活动普遍减慢。变化包括θ和低α功率普遍增加,除额叶ROI外所有区域的β功率降低,以及除右侧枕叶ROI外所有区域的γ功率降低。神经心理学评估显示初发患者存在异常的持续现象,这与中央顶叶ROI中低α功率增加有关。在整个帕金森病患者组中,疾病持续时间越长,右侧颞叶和右侧枕叶ROI中的低α功率越低,但与其他谱功率测量值无关。未发现谱功率与疾病分期、疾病严重程度或多巴胺模拟物剂量之间存在关联。在接受左旋多巴治疗的患者中,从“关”状态到“开”状态的变化与右侧额叶θ、左侧枕叶β和左侧颞叶γ功率降低以及右侧顶叶γ功率增加有关。振荡脑活动的普遍减慢是从最早临床阶段起非痴呆帕金森病患者的一个特征,其(很大程度上)独立于疾病持续时间、分期和严重程度,且几乎不受多巴胺模拟物治疗的影响。帕金森病的一些早期认知缺陷似乎与低α功率增加有关。我们推测在非痴呆帕金森病患者的谱功率变化中,功能减退的非多巴胺能上行神经递质系统发挥了作用。

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