Yokochi Fusako, Kato Kenji, Iwamuro Hirokazu, Kamiyama Tsutomu, Kimura Katsuo, Yugeta Akihiro, Okiyama Ryoichi, Taniguchi Makoto, Kumada Satoko, Ushiba Junichi
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
Department of Biosciences and Informatics, Faculty of Science and Technology, Keio University, Kanagawa, Japan.
Front Neurol. 2018 May 31;9:375. doi: 10.3389/fneur.2018.00375. eCollection 2018.
Pallidal deep brain stimulation (DBS) improves the symptoms of dystonia. The improvement processes of dystonic movements (phasic symptoms) and tonic symptoms differ. Phasic symptoms improve rapidly after starting DBS treatment, but tonic symptoms improve gradually. This difference implies distinct neuronal mechanisms for phasic and tonic symptoms in the underlying cortico-basal ganglia neuronal network. Phasic symptoms are related to the pallido-thalamo-cortical pathway. The pathway related to tonic symptoms has been assumed to be different from that for phasic symptoms. In the present study, local field potentials of the globus pallidus internus (GPi) and globus pallidus externus (GPe) and electroencephalograms from the motor cortex (MCx) were recorded in 19 dystonia patients to analyze the differences between the two types of symptoms. The 19 patients were divided into two groups, 10 with predominant phasic symptoms (phasic patients) and 9 with predominant tonic symptoms (tonic patients). To investigate the distinct features of oscillations and functional couplings across the GPi, GPe, and MCx by clinical phenotype, power and coherence were calculated over the delta (2-4 Hz), theta (5-7 Hz), alpha (8-13 Hz), and beta (14-35 Hz) frequencies. In phasic patients, the alpha spectral peaks emerged in the GPi oscillatory activities, and alpha GPi coherence with the GPe and MCx was higher than in tonic patients. On the other hand, delta GPi oscillatory activities were prominent, and delta GPi-GPe coherence was significantly higher in tonic than in phasic patients. However, there was no significant delta coherence between the GPi/GPe and MCx in tonic patients. These results suggest that different pathophysiological cortico-pallidal oscillations are related to tonic and phasic symptoms.
苍白球深部脑刺激（DBS）可改善肌张力障碍症状。肌张力障碍性运动（阶段性症状）和强直性症状的改善过程有所不同。阶段性症状在开始DBS治疗后迅速改善，但强直性症状则逐渐改善。这种差异意味着在潜在的皮质-基底神经节神经网络中，阶段性和强直性症状具有不同的神经元机制。阶段性症状与苍白球-丘脑-皮质通路有关。与强直性症状相关的通路被认为与阶段性症状的通路不同。在本研究中，记录了19例肌张力障碍患者的内侧苍白球（GPi）和外侧苍白球（GPe）的局部场电位以及运动皮质（MCx）的脑电图，以分析这两种症状类型之间的差异。19例患者分为两组，10例以阶段性症状为主（阶段性患者），9例以强直性症状为主（强直性患者）。为了通过临床表型研究GPi、GPe和MCx之间振荡和功能耦合的不同特征，计算了δ（2-4Hz）、θ（5-7Hz）、α（8-13Hz）和β（14-35Hz）频率范围内的功率和相干性。在阶段性患者中，α频谱峰值出现在GPi振荡活动中，并且GPi与GPe和MCx的α相干性高于强直性患者。另一方面，δ GPi振荡活动较为突出，强直性患者中δ GPi-GPe相干性明显高于阶段性患者。然而，强直性患者中GPi/GPe与MCx之间的δ相干性无显著差异。这些结果表明，不同的病理生理皮质-苍白球振荡与强直性和阶段性症状有关。
