Schara Ulrike, Busse Melanie, Timmann Dagmar, Gerwig Marcus
Department of Neuropediatrics, Developmental Neurology and Social Pediatrics,University of Duisburg-Essen, Essen, Germany.
Department of Neurology, University of Duisburg-Essen, Essen, Germany.
PLoS One. 2015 May 14;10(5):e0126528. doi: 10.1371/journal.pone.0126528. eCollection 2015.
Besides progressive muscle weakness cognitive deficits have been reported in patients with Duchenne muscular dystrophy (DMD). Cerebellar dysfunction has been proposed to explain cognitive deficits at least in part. In animal models of DMD disturbed Purkinje cell function has been shown following loss of dystrophin. Furthermore there is increasing evidence that the lateral cerebellum contributes to cognitive processing. In the present study cerebellar-dependent delay eyeblink conditioning, a form of associative learning, was used to assess cerebellar function in DMD children.
Delay eyeblink conditioning was examined in eight genetically defined male patients with DMD and in ten age-matched control subjects. Acquisition, timing and extinction of conditioned eyeblink responses (CR) were assessed during a single conditioning session.
Both groups showed a significant increase of CRs during the course of learning (block effect p < 0.001). CR acquisition was not impaired in DMD patients (mean total CR incidence 37.4 ± 17.6%) as compared to control subjects (36.2 ± 17.3%; group effect p = 0.89; group by block effect p = 0.38; ANOVA with repeated measures). In addition, CR timing and extinction was not different from controls.
Delay eyeblink conditioning was preserved in the present DMD patients. Because eyeblink conditioning depends on the integrity of the intermediate cerebellum, this older part of the cerebellum may be relatively preserved in DMD. The present findings agree with animal model data showing that the newer, lateral cerebellum is primarily affected in DMD.
除进行性肌无力外,杜氏肌营养不良症(DMD)患者还存在认知缺陷的报道。有人提出小脑功能障碍至少部分地解释了认知缺陷。在DMD动物模型中,肌营养不良蛋白缺失后已显示浦肯野细胞功能紊乱。此外,越来越多的证据表明小脑外侧参与认知加工。在本研究中,使用依赖小脑的延迟眨眼条件反射(一种联想学习形式)来评估DMD儿童的小脑功能。
对8名基因明确的男性DMD患者和10名年龄匹配的对照受试者进行延迟眨眼条件反射检查。在单次条件反射训练期间评估条件性眨眼反应(CR)的习得、定时和消退情况。
两组在学习过程中CR均显著增加(组块效应p<0.001)。与对照受试者(36.2±17.3%)相比,DMD患者的CR习得未受损(平均总CR发生率37.4±17.6%;组效应p = 0.89;组×组块效应p = 0.38;重复测量方差分析)。此外,CR定时和消退与对照组无差异。
本研究中的DMD患者保留了延迟眨眼条件反射。由于眨眼条件反射依赖于小脑中间部的完整性,小脑的这一较古老部分在DMD中可能相对保留。本研究结果与动物模型数据一致,表明较新的小脑外侧在DMD中主要受到影响。