Jha Ashwani, Litvak Vladimir, Taulu Samu, Thevathasan Wesley, Hyam Jonathan A, Foltynie Tom, Limousin Patricia, Bogdanovic Marko, Zrinzo Ludvic, Green Alexander L, Aziz Tipu Z, Friston Karl, Brown Peter
Sobell Department of Motor Neuroscience, UCL Institute of Neurology, Queen Square, London, UK.
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Cereb Cortex. 2017 Jan;27(1):54-67. doi: 10.1093/cercor/bhw340. Epub 2016 Nov 22.
Deep brain stimulation of the pedunculopontine nucleus and surrounding region (PPNR) is a novel treatment strategy for gait freezing in Parkinson's disease (PD). However, clinical results have been variable, in part because of the paucity of functional information that might help guide selection of the optimal surgical target. In this study, we use simultaneous magnetoencephalography and local field recordings from the PPNR in seven PD patients, to characterize functional connectivity with distant brain areas at rest. The PPNR was preferentially coupled to brainstem and cingulate regions in the alpha frequency (8-12 Hz) band and to the medial motor strip and neighboring areas in the beta (18-33 Hz) band. The distribution of coupling also depended on the vertical distance of the electrode from the pontomesencephalic line: most effects being greatest in the middle PPNR, which may correspond to the caudal pars dissipata of the pedunculopontine nucleus. These observations confirm the crucial position of the PPNR as a functional node between cortical areas such as the cingulate/ medial motor strip and other brainstem nuclei, particularly in the dorsal pons. In particular they suggest a special role for the middle PPNR as this has the greatest functional connectivity with other brain regions.
对脚桥核及其周围区域（PPNR）进行深部脑刺激是治疗帕金森病（PD）步态冻结的一种新策略。然而，临床结果参差不齐，部分原因是缺乏有助于指导选择最佳手术靶点的功能信息。在本研究中，我们对7名帕金森病患者同时进行脑磁图和PPNR局部场记录，以表征静息状态下与远处脑区的功能连接。PPNR在α频率（8-12Hz）波段优先与脑干和扣带区域耦合，在β（18-33Hz）波段优先与内侧运动皮层和邻近区域耦合。耦合的分布还取决于电极与脑桥中脑线的垂直距离：大多数效应在PPNR中部最为显著，这可能对应于脚桥核的尾部弥散部。这些观察结果证实了PPNR作为扣带/内侧运动皮层等皮质区域与其他脑干核团（特别是脑桥背侧）之间功能节点的关键位置。特别是，它们表明PPNR中部具有特殊作用，因为它与其他脑区具有最强的功能连接。
