Support Center for Advanced Imaging (SCAN), Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland.
Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Brain Behav. 2018 Jun;8(6):e00975. doi: 10.1002/brb3.975. Epub 2018 Apr 20.
Serving as a pilot study of poststroke pharmacotherapy, the present investigation was intended to establish the effect of a single dose of escitalopram on motor task performance in normal volunteers.
Ten healthy volunteers of median age 63 years including four females performed a well-studied tactile manipulation task in two fMRI sessions using a double-blind cross-over design. The sessions began approximately three hours after ingestion of 20 mg escitalopram or placebo presented in pseudorandom order. The fMRI image sequences were submitted to principal component analysis (PCA).
Based on volume correlations of task-related principal components with the mean component images derived in our previous study, we established the reproducibility of two networks of sensorimotor activity proposed there. The network reflecting motor control (cerebral pattern I) appeared invariably in placebo and verum conditions. In contrast, the other network, attributed to diminished motor control due to distracting mental processing (cerebral pattern II), emerged less regularly and exhibited more variability. Second-level PCAs of both conditions confirmed the findings of the initial analysis. Specifically, it validated the dominant and invariable expression of cerebral pattern I after application of a single dose of escitalopram. Dynamic causal modeling confirmed enhanced motor output as a result of a significantly increased connectivity between primary motor cortex and dorsal premotor cortex.
This pilot study suggests the promise of stimulation by a specific serotonin reuptake inhibitor in regard to recovery and preservation of motor control after stroke.
作为卒中后药物治疗的初步研究，本研究旨在确定单次服用艾司西酞普兰对健康志愿者运动任务表现的影响。
10 名年龄中位数为 63 岁的健康志愿者（包括 4 名女性）在两次 fMRI 会话中使用双盲交叉设计进行了一项经过充分研究的触觉操作任务。会话在大约三小时后开始服用 20mg 艾司西酞普兰或安慰剂，以伪随机顺序呈现。将 fMRI 图像序列提交给主成分分析（PCA）。
基于与我们之前研究中得出的平均成分图像相关的任务相关主成分的体积相关性，我们建立了两个运动活动网络的重现性，这些网络在以前的研究中提出。反映运动控制的网络（大脑模式 I）在安慰剂和真实条件下始终出现。相比之下，另一个网络归因于由于分散注意力的心理处理而导致的运动控制减弱（大脑模式 II），出现的不那么规则，表现出更多的可变性。两种条件的二级 PCAs 证实了初始分析的结果。具体来说，它验证了在单次服用艾司西酞普兰后大脑模式 I 的主要和不变表达。动态因果建模证实了由于初级运动皮层和背侧运动前皮层之间的连接性显著增加，运动输出增强。
这项初步研究表明，特定的 5-羟色胺再摄取抑制剂在卒中后运动控制的恢复和保护方面具有一定的应用前景。
