Department of Neuroscience, Institute of Neurology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy.
J Neural Transm (Vienna). 2011 Oct;118(10):1477-86. doi: 10.1007/s00702-011-0705-7. Epub 2011 Sep 9.
In Parkinson's disease (PD), the effects of deep brain stimulation of the pedunculopontine nucleus (PPTg-DBS) on gait has been object of international debate. Some evidence demonstrated that, in the late swing-early stance phase of gait cycle, a reduced surface electromyographic activation (sEMG) of tibialis anterior (TA) is linked to the striatal dopamine deficiency in PD patients. In the present study we report preliminary results on the effect of PPTg-DBS on electromyographic patterns during gait in individual PD patients. To evaluate the sEMG amplitude of TA, the root mean square (RMS) of the TA burst in late swing-early stance phase (RMS-A) was normalized as a percent of the RMS of the TA burst in late stance-early swing (RMS-B). We studied three male patients in the following conditions: on PPTg-DBS/on L: -dopa, on PPTg-DBS/off L: -dopa, off PPTg-DBS/on L: -dopa, off PPTg-DBS/off L: -dopa. For each assessment the UPDRS III was filled in. We observed no difference between on PPTg-DBS/off L: -dopa and off PPTg-DBS/off L: -dopa in UPDRS III scores. In off PPTg-DBS/off L: -dopa, patient A (right implant) showed absence of the right and left RMSA, respectively, in 80% and 83% of gait cycles. Patient B (right implant) showed absence of the right RMS-A in 86% of cycles. RMS-A of the patient C (left implant) was bilaterally normal. In on PPTg- DBS/off L: -dopa, no patient showed reduced RMS-A. Although the very low number of subjects we evaluated, our observations suggest that PPTg plays a role in modulating TA activation pattern during the steady state of gait.
在帕金森病 (PD) 中，苍白球内侧部 (GPi) 脑深部电刺激 (DBS) 对步态的影响一直是国际争论的焦点。一些证据表明，在步态周期的晚期摆动-早期支撑阶段，PD 患者的胫骨前肌 (TA) 的表面肌电图激活 (sEMG) 减少与纹状体多巴胺缺乏有关。在本研究中，我们报告了个别 PD 患者的 PPTg-DBS 对步态中肌电图模式影响的初步结果。为了评估 TA 的 sEMG 幅度，将晚期摆动-早期支撑阶段 TA 爆发的均方根 (RMS) (RMS-A) 归一化为晚期支撑-早期摆动阶段 TA 爆发的 RMS (RMS-B) 的百分比。我们在以下情况下研究了 3 名男性患者：在 PPTg-DBS/左：-dopa，在 PPTg-DBS/关：-dopa，在 PPTg-DBS/左：-dopa，在 PPTg-DBS/关：-dopa。对于每个评估，填写 UPDRS III。我们观察到 PPTg-DBS/关：-dopa 和 PPTg-DBS/关：-dopa 之间在 UPDRS III 评分方面没有差异。在 PPTg-DBS/关：-dopa 时，患者 A（右侧植入物）在 80%和 83%的步态周期中分别显示右侧和左侧 RMSA 缺失。患者 B（右侧植入物）在 86%的周期中显示右侧 RMS-A 缺失。患者 C（左侧植入物）的 RMS-A 双侧正常。在 PPTg-DBS/关：-dopa 时，没有患者显示 RMS-A 减少。尽管我们评估的受试者数量非常少，但我们的观察结果表明，PPTg 在调节步态稳定状态下 TA 激活模式方面发挥作用。
