Gallea Cecile, Ewenczyk Claire, Degos Bertrand, Welter Marie-Laure, Grabli David, Leu-Semenescu Smaranda, Valabregue Romain, Berroir Pierre, Yahia-Cherif Lydia, Bertasi Eric, Fernandez-Vidal Sara, Bardinet Eric, Roze Emmanuel, Benali Habib, Poupon Cyril, François Chantal, Arnulf Isabelle, Lehéricy Stéphane, Vidailhet Marie
Centre de Neuroimagerie de Recherche (CENIR), Institut du Cerveau et de la Moelle, ICM, Paris, France.
Inserm, U 1127, Paris, France.
Mov Disord. 2017 May;32(5):693-704. doi: 10.1002/mds.26923. Epub 2017 Feb 6.
The objective of this study was to investigate pedunculopontine nucleus network dysfunctions that mediate impaired postural control and sleep disorder in Parkinson's disease.
We examined (1) Parkinson's disease patients with impaired postural control and rapid eye movement sleep behavior disorder (further abbreviated as sleep disorder), (2) Parkinson's disease patients with sleep disorder only, (3) Parkinson's disease patients with neither impaired postural control nor sleep disorder, and (4) healthy volunteers. We assessed postural control with clinical scores and biomechanical recordings during gait initiation. Participants had video polysomnography, daytime sleepiness self-evaluation, and resting-state functional MRIs.
Patients with impaired postural control and sleep disorder had longer duration of anticipatory postural adjustments during gait initiation and decreased functional connectivity between the pedunculopontine nucleus and the supplementary motor area in the locomotor network that correlated negatively with the duration of anticipatory postural adjustments. Both groups of patients with sleep disorder had decreased functional connectivity between the pedunculopontine nucleus and the anterior cingulate cortex in the arousal network that correlated with daytime sleepiness. The degree of dysfunction in the arousal network was related to the degree of connectivity in the locomotor network in all patients with sleep disorder, but not in patients without sleep disorder or healthy volunteers.
These results shed light on the functional neuroanatomy of pedunculopontine nucleus networks supporting the clinical manifestation and the interdependence between sleep and postural control impairments in Parkinson's disease. © 2016 International Parkinson and Movement Disorder Society.
本研究的目的是调查在帕金森病中介导姿势控制受损和睡眠障碍的脚桥核网络功能障碍。
我们检查了（1）姿势控制受损且有快速眼动睡眠行为障碍（以下简称为睡眠障碍）的帕金森病患者，（2）仅患有睡眠障碍的帕金森病患者，（3）既无姿势控制受损也无睡眠障碍的帕金森病患者，以及（4）健康志愿者。我们在步态起始期间通过临床评分和生物力学记录评估姿势控制。参与者进行了视频多导睡眠监测、日间嗜睡自我评估和静息态功能磁共振成像。
姿势控制受损且有睡眠障碍的患者在步态起始期间的预期姿势调整持续时间更长，并且在运动网络中脚桥核与辅助运动区之间的功能连接性降低，这与预期姿势调整的持续时间呈负相关。两组有睡眠障碍的患者在觉醒网络中脚桥核与前扣带回皮质之间的功能连接性降低，这与日间嗜睡相关。在所有有睡眠障碍的患者中，觉醒网络的功能障碍程度与运动网络的连接程度相关，但在无睡眠障碍的患者或健康志愿者中则不然。
这些结果揭示了支持帕金森病临床表现以及睡眠与姿势控制障碍之间相互依存关系的脚桥核网络的功能神经解剖学。© 2016国际帕金森和运动障碍协会。
