Quattrocchi Carlo Cosimo, de Pandis Maria Francesca, Piervincenzi Claudia, Galli Manuela, Melgari Jean Marc, Salomone Gaetano, Sale Patrizio, Mallio Carlo Augusto, Carducci Filippo, Stocchi Fabrizio
Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
Neuromotor Rehabilitation Unit, San Raffaele Hospital, Cassino, Italy.
PLoS One. 2015 Oct 15;10(10):e0137977. doi: 10.1371/journal.pone.0137977. eCollection 2015.
The present study shows the results of a double-blind sham-controlled pilot trial to test whether measurable stimulus-specific functional connectivity changes exist after Automatic Mechanical Peripheral Stimulation (AMPS) in patients with idiopathic Parkinson Disease.
Eleven patients (6 women and 5 men) with idiopathic Parkinson Disease underwent brain fMRI immediately before and after sham or effective AMPS. Resting state Functional Connectivity (RSFC) was assessed using the seed-ROI based analysis. Seed ROIs were positioned on basal ganglia, on primary sensory-motor cortices, on the supplementary motor areas and on the cerebellum. Individual differences for pre- and post-effective AMPS and pre- and post-sham condition were obtained and first entered in respective one-sample t-test analyses, to evaluate the mean effect of condition.
Effective AMPS, but not sham stimulation, induced increase of RSFC of the sensory motor cortex, nucleus striatum and cerebellum. Secondly, individual differences for both conditions were entered into paired group t-test analysis to rule out sub-threshold effects of sham stimulation, which showed stronger connectivity of the striatum nucleus with the right lateral occipital cortex and the cuneal cortex (max Z score 3.12) and with the right anterior temporal lobe (max Z score 3.42) and of the cerebellum with the right lateral occipital cortex and the right cerebellar cortex (max Z score 3.79).
Our results suggest that effective AMPS acutely increases RSFC of brain regions involved in visuo-spatial and sensory-motor integration.
This study provides Class II evidence that automatic mechanical peripheral stimulation is effective in modulating brain functional connectivity of patients with Parkinson Disease at rest.
Clinical Trials.gov NCT01815281.
本研究展示了一项双盲假刺激对照试验的结果，以测试特发性帕金森病患者在接受自动机械外周刺激（AMPS）后是否存在可测量的刺激特异性功能连接变化。
11名特发性帕金森病患者（6名女性和5名男性）在假刺激或有效AMPS前后立即接受脑部功能磁共振成像（fMRI）。使用基于种子兴趣区（ROI）的分析评估静息态功能连接（RSFC）。种子ROI位于基底神经节、初级感觉运动皮层、辅助运动区和小脑。获取有效AMPS前后以及假刺激前后的个体差异，并首先进行各自的单样本t检验分析，以评估条件的平均效应。
有效AMPS而非假刺激诱导感觉运动皮层、纹状体核和小脑的RSFC增加。其次，将两种条件下的个体差异进行配对组t检验分析，以排除假刺激的阈下效应，结果显示纹状体核与右侧枕叶外侧皮层和楔叶皮层（最大Z值3.12）以及与右侧颞叶前部（最大Z值3.42）之间的连接更强，小脑与右侧枕叶外侧皮层和右侧小脑皮层之间的连接更强（最大Z值3.79）。
我们的结果表明，有效AMPS可急性增加参与视觉空间和感觉运动整合的脑区的RSFC。
本研究提供了II类证据，表明自动机械外周刺激在调节帕金森病患者静息时的脑功能连接方面是有效的。
ClinicalTrials.gov NCT01815281。
