Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan Department of Neuromodulation and Neurosurgery, Center for Advanced Science and Innovation, Osaka University, Osaka, Japan Department of Ecosocial System Engineering, Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan.
Pain. 2011 Apr;152(4):860-865. doi: 10.1016/j.pain.2010.12.038.
Patients with Parkinson's disease (PD) reportedly show deficits in sensory processing in addition to motor symptoms. However, little is known about the effects of bilateral deep brain stimulation of the subthalamic nucleus (STN-DBS) on temperature sensation as measured by quantitative sensory testing (QST). This study was designed to quantitatively evaluate the effects of STN-DBS on temperature sensation and pain in PD patients. We conducted a QST study comparing the effects of STN-DBS on cold sense thresholds (CSTs) and warm sense thresholds (WSTs) as well as on cold-induced and heat-induced pain thresholds (CPT and HPT) in 17 PD patients and 14 healthy control subjects. The CSTs and WSTs of patients were significantly smaller during the DBS-on mode when compared with the DBS-off mode (P<.001), whereas the CSTs and WSTs of patients in the DBS-off mode were significantly greater than those of healthy control subjects (P<.02). The CPTs and HPTs in PD patients were significantly larger on the more affected side than on the less affected side (P<.02). Because elevations in thermal sense and pain thresholds of QST are reportedly almost compatible with decreases in sensation, our findings confirm that temperature sensations may be disturbed in PD patients when compared with healthy persons and that STN-DBS can be used to improve temperature sensation in these patients. The mechanisms underlying our findings are not well understood, but improvement in temperature sensation appears to be a sign of modulation of disease-related brain network abnormalities.
据报道,帕金森病(PD)患者除了运动症状外,还存在感觉处理缺陷。然而,对于丘脑底核(STN)双侧深部脑刺激(STN-DBS)对定量感觉测试(QST)测量的温度感觉的影响知之甚少。本研究旨在定量评估 STN-DBS 对 PD 患者温度感觉和疼痛的影响。我们进行了一项 QST 研究,比较了 17 名 PD 患者和 14 名健康对照者在 STN-DBS 开启和关闭模式下冷感觉阈值(CSTs)和温感觉阈值(WSTs)以及冷诱痛阈值(CPT)和热诱痛阈值(HPT)的影响。与 DBS 关闭模式相比,患者在 DBS 开启模式下 CSTs 和 WSTs 明显较小(P<.001),而 DBS 关闭模式下患者的 CSTs 和 WSTs 明显大于健康对照组(P<.02)。PD 患者的 CPTs 和 HPTs 在受影响较大的一侧明显大于受影响较小的一侧(P<.02)。由于 QST 中热感觉和痛觉阈值的升高据称几乎与感觉减退一致,我们的研究结果证实,与健康人相比,PD 患者的温度感觉可能受到干扰,而 STN-DBS 可用于改善这些患者的温度感觉。我们研究结果的机制尚不清楚,但温度感觉的改善似乎是疾病相关脑网络异常调节的标志。