Centre for Neuroscience, Imperial College London, Charing Cross Hospital, London, UK.
Eur J Neurosci. 2012 Jul;36(2):2252-9. doi: 10.1111/j.1460-9568.2012.08086.x.
Deep brain stimulation (DBS) is a successful surgical therapy used to treat the disabling symptoms of movement disorders such as Parkinson's disease. It involves the chronic stimulation of disorder-specific nuclei. However, the mechanisms that lead to clinical improvements remain unclear. Consequently, this slows the optimization of present-day DBS therapy and hinders its future development and application. We used a computational model to calculate the distribution of electric potential induced by DBS and study the effect of stimulation on the spiking activity of a subthalamic nucleus (STN) projection neuron. We previously showed that such a model can reveal detailed spatial effects of stimulation in the vicinity of the electrode. However, this multi-compartmental STN neuron model can fire in either a burst or tonic mode and, in this study, we hypothesized that the firing mode of the cell will have a major impact on the DBS-induced effects. Our simulations showed that the bursting model exhibits behaviour observed in studies of high-frequency stimulation of STN neurons, such as the presence of a silent period at stimulation offset and frequency-dependent stimulation effects. We validated the model by simulating the clinical parameter settings used for a Parkinsonian patient and showed, in a patient-specific anatomical model, that the region of affected tissue is consistent with clinical observations of the optimal DBS site. Our results demonstrated a method of quantitatively assessing neuronal changes induced by DBS, to maximize therapeutic benefit and minimize unwanted side effects.
脑深部电刺激(DBS)是一种成功的外科治疗方法,用于治疗运动障碍(如帕金森病)等导致身体残疾的症状。它涉及到对特定核团的慢性刺激。然而,导致临床改善的机制仍不清楚。因此,这减缓了目前 DBS 治疗的优化,并阻碍了其未来的发展和应用。我们使用计算模型来计算 DBS 诱导的电势分布,并研究刺激对丘脑底核(STN)投射神经元放电活动的影响。我们之前曾表明,这种模型可以揭示刺激在电极附近的详细空间效应。然而,这种多室 STN 神经元模型可以以爆发或持续模式放电,在本研究中,我们假设细胞的放电模式将对 DBS 诱导的效应产生重大影响。我们的模拟表明,爆发模型表现出 STN 神经元高频刺激研究中观察到的行为,例如刺激结束时存在静默期和频率依赖性刺激效应。我们通过模拟帕金森病患者的临床参数设置来验证模型,并在患者特定的解剖模型中显示,受影响组织的区域与 DBS 最佳位置的临床观察一致。我们的研究结果提供了一种定量评估 DBS 诱导的神经元变化的方法,以最大限度地提高治疗效果并最小化不必要的副作用。