IRCCS Neuromed Institute, Pozzilli, Province of Isernia, Italy.
IRCCS Neuromed Institute, Pozzilli, Province of Isernia, Italy; Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
Neurobiol Aging. 2018 Sep;69:230-238. doi: 10.1016/j.neurobiolaging.2018.05.026. Epub 2018 May 29.
In frontotemporal dementia (FTD), the behavioral variant (bv-FTD) and nonfluent variant of primary progressive aphasia (nfv-PPA) reflect a prominent neurodegenerative involvement of the frontal lobe networks, which may include the premotor and motor areas and thus cause heterogeneous clinical symptoms including parkinsonism. With the technique of transcranial magnetic stimulation, we investigated long-term potentiation- and long-term depression-like plasticity in the primary motor cortex of bv-FTD and nfv-PPA patients, with and without parkinsonism, by using the theta-burst stimulation (TBS) protocol. We applied the intermittent TBS and continuous TBS in 20 FTD patients and 18 age-matched healthy subjects. Results were also compared with those achieved in a cohort of age-matched patients with Parkinson's disease. The responses to TBS were abnormal in FTD patients with parkinsonism. By contrast, the TBS induced normal responses in patients with both nfv-PPA and bv-FTD without parkinsonism. Finally, responses to TBS were comparable in patients with FTD with parkinsonism and patients with Parkinson's disease. We provide evidence of abnormal primary motor cortex long-term potentiation-/long-term depression-like plasticity in patients with FTD and parkinsonism suggesting neurodegenerative processes in the corticobasal ganglia-thalamo-cortical motor networks in these patients.
在额颞叶痴呆（FTD）中，行为变异型（bv-FTD）和原发性进行性失语非流利型（nfv-PPA）反映了额叶网络的明显神经退行性累及，其中可能包括运动前区和运动区，从而导致包括帕金森病在内的异质临床症状。我们使用经颅磁刺激技术，通过 theta 爆发刺激（TBS）方案，研究了伴有和不伴有帕金森病的 bv-FTD 和 nfv-PPA 患者初级运动皮层的长时程增强和长时程抑制样可塑性。我们在 20 名 FTD 患者和 18 名年龄匹配的健康受试者中应用了间歇性 TBS 和连续性 TBS。结果还与年龄匹配的帕金森病患者队列的结果进行了比较。帕金森病患者的 TBS 反应异常。相比之下，nfv-PPA 和 bv-FTD 无帕金森病患者的 TBS 诱导出正常反应。最后，帕金森病患者和 FTD 伴帕金森病患者的 TBS 反应相当。我们提供了 FTD 伴帕金森病患者初级运动皮层长时程增强/长时程抑制样可塑性异常的证据，表明这些患者的皮质基底节-丘脑-皮质运动网络存在神经退行性过程。
