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Cortical Plasticity Induction by Pairing Subthalamic Nucleus Deep-Brain Stimulation and Primary Motor Cortical Transcranial Magnetic Stimulation in Parkinson's Disease.

作者信息

Udupa Kaviraja, Bahl Nina, Ni Zhen, Gunraj Carolyn, Mazzella Filomena, Moro Elena, Hodaie Mojgan, Lozano Andres M, Lang Anthony E, Chen Robert

机构信息

Edmond J. Safra Program in Parkinson's Disease, Division of Neurology and.

Edmond J. Safra Program in Parkinson's Disease, Division of Neurology and Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation, University Health Network, University of Toronto, Toronto, Ontario M4G 3V9, Canada, and.

出版信息

J Neurosci. 2016 Jan 13;36(2):396-404. doi: 10.1523/JNEUROSCI.2499-15.2016.


DOI:10.1523/JNEUROSCI.2499-15.2016
PMID:26758832
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6602027/
Abstract

UNLABELLED: Noninvasive brain stimulation studies have shown abnormal motor cortical plasticity in Parkinson's disease (PD). These studies used peripheral nerve stimulation paired with transcranial magnetic stimulation (TMS) to primary motor cortex (M1) at specific intervals to induce plasticity. Induction of cortical plasticity through stimulation of the basal ganglia (BG)-M1 connections has not been studied. In the present study, we used a novel technique of plasticity induction by repeated pairing of deep-brain stimulation (DBS) of the BG with M1 stimulation using TMS. We hypothesize that repeated pairing of subthalamic nucleus (STN)-DBS and M1-TMS at specific time intervals will lead to plasticity in the M1. Ten PD human patients with STN-DBS were studied in the on-medication state with DBS set to 3 Hz. The interstimulus intervals (ISIs) between STN-DBS and TMS that produced cortical facilitation were determined individually for each patient. Three plasticity induction conditions with repeated pairings (180 times) at specific ISIs (∼ 3 and ∼ 23 ms) that produced cortical facilitation and a control ISI of 167 ms were tested in random order. Repeated pairing of STN-DBS and M1-TMS at short (∼ 3 ms) and medium (∼ 23 ms) latencies increased M1 excitability that lasted for at least 45 min, whereas the control condition (fixed ISI of 167 ms) had no effect. There were no specific changes in motor thresholds, intracortical circuits, or recruitment curves. Our results indicate that paired-associative cortical plasticity can be induced by repeated STN and M1 stimulation at specific intervals. These results show that STN-DBS can modulate cortical plasticity. SIGNIFICANCE STATEMENT: We introduced a new experimental paradigm to test the hypothesis that pairing subthalamic nucleus deep-brain stimulation (STN-DBS) with motor cortical transcranial magnetic stimulation (M1-TMS) at specific times can induce cortical plasticity in patients with Parkinson's disease (PD). We found that repeated pairing of STN-DBS with TMS at short (∼ 3 ms) and medium (∼ 23 ms) intervals increased cortical excitability that lasted for up to 45 min, whereas the control condition (fixed latency of 167 ms) had no effects on cortical excitability. This is the first demonstration of associative plasticity in the STN-M1 circuits in PD patients using this novel technique. The potential therapeutic effects of combining DBS and noninvasive cortical stimulation should be investigated further.

摘要

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本文引用的文献

[1]
The mechanisms of action of deep brain stimulation and ideas for the future development.

Prog Neurobiol. 2015-8-19

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Front Neural Circuits. 2013-2-13

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N Engl J Med. 2013-2-14

[10]
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Ageing Res Rev. 2013-2-4

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