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深部脑刺激与药物治疗对帕金森病体感加工的不同影响。

Differentiated effects of deep brain stimulation and medication on somatosensory processing in Parkinson's disease.

作者信息

Sridharan Kousik Sarathy, Højlund Andreas, Johnsen Erik Lisbjerg, Sunde Niels Aagaard, Johansen Lars Gottfried, Beniczky Sándor, Østergaard Karen

机构信息

Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Nørrebrogade 44, 8000 Aarhus, Denmark.

Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Nørrebrogade 44, 8000 Aarhus, Denmark.

出版信息

Clin Neurophysiol. 2017 Jul;128(7):1327-1336. doi: 10.1016/j.clinph.2017.04.014. Epub 2017 May 2.

Abstract

OBJECTIVES

Deep brain stimulation (DBS) and dopaminergic medication effectively alleviate the motor symptoms in Parkinson's disease (PD) patients, but their effects on the sensory symptoms of PD are still not well understood. To explore early somatosensory processing in PD, we recorded magnetoencephalography (MEG) from thirteen DBS-treated PD patients and ten healthy controls during median nerve stimulation.

METHODS

PD patients were measured during DBS-treated, untreated and dopaminergic-medicated states. We focused on early cortical somatosensory processing as indexed by N20m, induced gamma augmentation (31-45Hz and 55-100Hz) and induced beta suppression (13-30Hz). PD patients' motor symptoms were assessed by UPDRS-III.

RESULTS

Using Bayesian statistics, we found positive evidence for differentiated effects of treatments on the induced gamma augmentation (31-45Hz) with highest gamma in the dopaminergic-medicated state and lowest in the DBS-treated and untreated states. In contrast, UPDRS-III scores showed beneficial effects of both DBS and dopaminergic medication on the patients' motor symptoms. Furthermore, treatments did not affect the amplitude of N20m.

CONCLUSIONS

Our results suggest differentiated effects of DBS and dopaminergic medication on cortical somatosensory processing in PD patients despite consistent ameliorating effects of both treatments on PD motor symptoms.

SIGNIFICANCE

The differentiated effect suggests differences in the effect mechanisms of the two treatments.

摘要

目的

深部脑刺激(DBS)和多巴胺能药物可有效缓解帕金森病(PD)患者的运动症状,但其对PD感觉症状的影响仍未得到充分了解。为探究PD患者早期体感加工情况,我们在正中神经刺激期间,对13例接受DBS治疗的PD患者和10名健康对照者进行了脑磁图(MEG)记录。

方法

在DBS治疗状态、未治疗状态和多巴胺能药物治疗状态下对PD患者进行测量。我们重点关注由N20m、诱发γ波增强(31 - 45Hz和55 - 100Hz)以及诱发β波抑制(13 - 30Hz)所表征的早期皮层体感加工。通过统一帕金森病评定量表第三部分(UPDRS - III)评估PD患者的运动症状。

结果

使用贝叶斯统计方法,我们发现有确凿证据表明不同治疗方式对诱发γ波增强(31 - 45Hz)有不同影响,在多巴胺能药物治疗状态下γ波最强,在DBS治疗状态和未治疗状态下γ波最弱。相比之下,UPDRS - III评分显示DBS和多巴胺能药物对患者的运动症状均有有益影响。此外,不同治疗方式并未影响N20m的波幅。

结论

我们的结果表明,尽管DBS和多巴胺能药物对PD运动症状均有持续改善作用,但它们对PD患者皮层体感加工的影响存在差异。

意义

这种差异效应表明两种治疗方式的作用机制存在不同。

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