Department of Neurology, University Hospital Cologne, Cologne, Germany.
Eur J Neurosci. 2010 Oct;32(7):1202-14. doi: 10.1111/j.1460-9568.2010.07362.x. Epub 2010 Sep 8.
Implantation of electrodes in the subthalamic nucleus (STN) for deep brain stimulation is a well-established method to ameliorate motor symptoms in patients suffering from Parkinson's disease (PD). This study investigated the pathophysiology of rest and postural tremor in PD. In 14 patients with PD, we recorded intraoperatively local field potentials (LFPs) in the STN (at different recording depths) and electromyographic signals (EMGs) of the contralateral forearm. Using coherence analysis we analysed tremor epochs both at rest and hold conditions in patients of the akinetic-rigid or of the tremor-dominant PD subtype. Data analysis revealed significant LFP-EMG coherence during periods of rest and postural tremor. However, strong differences between both tremor types were observed: local maxima (cluster) of rest and postural tremor did not match. Additionally, during rest tremor coherence occurred significantly more frequently at single tremor frequency than at double tremor frequency in tremor-dominant as well as in akinetic-rigid patients. In contrast, during postural tremor in patients with akinetic-rigid PD coherence was predominantly at double tremor frequency. The data suggest a specific topography of 'tremor clusters' for rest and postural tremor. Furthermore, we presume that the same tremor mechanisms exist in patients with tremor-dominant and akinetic-rigid PD, but to different degrees.
电极植入丘脑底核（STN）进行深部脑刺激是改善帕金森病（PD）患者运动症状的一种成熟方法。本研究调查了 PD 静止性震颤和姿势性震颤的病理生理学。在 14 名 PD 患者中，我们记录了 STN 中的术中局部场电位（LFPs）（在不同的记录深度）和对侧前臂的肌电图信号（EMGs）。我们使用相干分析分析了无动性僵硬或震颤主导型 PD 亚型患者的静止和保持条件下的震颤期。数据分析显示，在休息和姿势性震颤期间存在显著的 LFPs-EMGs 相干性。然而，两种震颤类型之间存在明显差异：静止和姿势性震颤的局部最大值（簇）不匹配。此外，在震颤主导型和无动性僵硬型患者中，休息震颤时相干性在单个震颤频率下发生的频率明显高于双震颤频率，而在姿势性震颤期间则相反。相反，在无动性僵硬型 PD 患者的姿势性震颤期间，相干性主要在双震颤频率下发生。这些数据表明，静止性震颤和姿势性震颤具有特定的“震颤簇”拓扑结构。此外，我们推测，震颤主导型和无动性僵硬型 PD 患者存在相同的震颤机制，但程度不同。
