底丘脑核刺激通过脑干运动中枢改善帕金森步态。
Subthalamic nucleus stimulation improves Parkinsonian gait via brainstem locomotor centers.
机构信息
Department of Neurology, University Hospital, University of Cologne, Köln, Germany.
Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.
出版信息
Mov Disord. 2015 Jul;30(8):1121-5. doi: 10.1002/mds.26229. Epub 2015 Apr 25.
BACKGROUND
Subthalamic deep brain stimulation (STN-DBS) can ameliorate gait disturbances in Parkinson's disease (PD). Using motor imagery and positron emission tomography (PET), we investigated how STN-DBS interacts with supraspinal locomotor centers in PD.
METHODS
Ten PD patients with bilateral STN-DBS actually walked or stood still under STN-DBS ON or OFF conditions. Directly thereafter, subjects imagined walking or standing while changes in regional cerebral blood flow were measured by PET.
RESULTS
Independent of STN-DBS, imagined walking distance correlated with imagery duration. Compared with STN-DBS OFF, STN-DBS ON improved actual gait and increased imagined walking distance. Imagery of gait (vs. stance) induced activity in the supplementary motor area and the right superior parietal lobule for both STN-DBS conditions. The improvement of imagined gait during STN-DBS ON led to activity changes in the pedunculopontine nucleus/mesencephalic locomotor region (PPN/MLR).
CONCLUSIONS
Data suggest that STN-DBS improves Parkinsonian gait by modulating PPN/MLR activity.
背景
丘脑底核深部脑刺激（STN-DBS）可改善帕金森病（PD）的步态障碍。我们运用运动想象和正电子发射断层扫描（PET）技术，研究了 STN-DBS 如何与 PD 中的脊髓上位运动中枢相互作用。
方法
10 名双侧 STN-DBS 的 PD 患者在 STN-DBS 开启或关闭条件下实际行走或静止站立。直接在这之后，通过 PET 测量脑血流变化，受测者想象行走或站立。
结果
无论 STN-DBS 状态如何，想象行走的距离都与想象持续时间相关。与 STN-DBS 关闭相比，STN-DBS 开启改善了实际步态并增加了想象行走的距离。在两种 STN-DBS 条件下，步态想象（与站立相比）都能引起辅助运动区和右侧顶叶上回的活动。STN-DBS 开启时想象步态的改善导致了动眼神经核/中脑运动区（PPN/MLR）的活动变化。
结论
数据表明，STN-DBS 通过调节 PPN/MLR 的活动来改善帕金森步态。
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