Cao Chunyan, Zhang Huiwei, Li Dianyou, Zhan Shikun, Zhang Jing, Zhang Xiaoxiao, Zuo Chuantao, Sun Bomin
Department of Functional Neurosurgery, Affiliated Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Stereotact Funct Neurosurg. 2017;95(2):93-101. doi: 10.1159/000455930. Epub 2017 Mar 4.
Adjustment of the motor circuitry has been described in the treatment of Parkinson disease (PD).
To evaluate the modulation of the motor circuitry of PD patients by subthalamic deep brain stimulation (STN DBS) using 18F-fluorodeoxyglucose (FDG) and positron emission tomography (PET).
Resting-state brain 18F-FDG PET imaging was performed for 8 PD patients before surgery and also 1 year after STN DBS treatment; changes in regional glucose metabolism were identified. The PD-related pattern (PDRP) of metabolic covariation was also evaluated. In addition, the correlations between glucose metabolism and clinical alleviation were determined.
Pronounced elevations in parietal and occipital glucose metabolism due to STN DBS modification were found; an obvious reduction in caudate, putamen, cerebellum, and frontal cortex glucose metabolism was detected after STN DBS interventions. The alleviation of rigidity correlated with an increment in glucose metabolism in the parietal lobe. STN DBS inhibited the PDRP; the decrease in the PDRP correlated with the inhibition of the glucose metabolism of the caudate and the augmented glucose metabolism of the occipital lobe.
STN DBS modulates cortical function through the cortical-striatothalamocortial motor circuitry and cerebellothalamocortical motor circuitry.
帕金森病（PD）治疗中已描述了运动神经回路的调整。
使用18F-氟脱氧葡萄糖（FDG）和正电子发射断层扫描（PET）评估丘脑底核深部脑刺激（STN DBS）对PD患者运动神经回路的调节作用。
对8例PD患者在手术前及STN DBS治疗1年后进行静息态脑18F-FDG PET成像；确定区域葡萄糖代谢的变化。还评估了代谢协变的PD相关模式（PDRP）。此外，确定了葡萄糖代谢与临床缓解之间的相关性。
发现由于STN DBS改变，顶叶和枕叶葡萄糖代谢明显升高；STN DBS干预后，尾状核、壳核、小脑和额叶皮质葡萄糖代谢明显降低。强直的缓解与顶叶葡萄糖代谢的增加相关。STN DBS抑制了PDRP；PDRP的降低与尾状核葡萄糖代谢的抑制和枕叶葡萄糖代谢的增加相关。
STN DBS通过皮质-纹状体-丘脑-皮质运动神经回路和小脑-丘脑-皮质运动神经回路调节皮质功能。
