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左旋多巴调节帕金森病强直和相位性运动活动模式下,丘脑底核与肌肉活动之间上β频段的功能连接。

Levodopa Modulates Functional Connectivity in the Upper Beta Band Between Subthalamic Nucleus and Muscle Activity in Tonic and Phasic Motor Activity Patterns in Parkinson's Disease.

作者信息

Ramirez Pasos Uri E, Steigerwald Frank, Reich Martin M, Matthies Cordula, Volkmann Jens, Reese René

机构信息

Department of Neurology, University Hospital Würzburg, Würzburg, Germany.

Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany.

出版信息

Front Hum Neurosci. 2019 Jul 2;13:223. doi: 10.3389/fnhum.2019.00223. eCollection 2019.

Abstract

: Striatal dopamine depletion disrupts basal ganglia function and causes Parkinson's disease (PD). The pathophysiology of the dopamine-dependent relationship between basal ganglia signaling and motor control, however, is not fully understood. We obtained simultaneous recordings of local field potentials (LFPs) from the subthalamic nucleus (STN) and electromyograms (EMGs) in patients with PD to investigate the impact of dopaminergic state and movement on long-range beta functional connectivity between basal ganglia and lower motor neurons. : Eight PD patients were investigated 3 months after implantation of a deep brain stimulation (DBS)-system capable of recording LFPs chronically-implanted leads (Medtronic, ACTIVA PC+S). We analyzed STN spectral power and its coherence with EMG in the context of two different movement paradigms (tonic wrist extension vs. alternating wrist extension and flexion) and the effect of levodopa (L-Dopa) intake using an unbiased data-driven approach to determine regions of interest (ROI). : Two ROIs capturing prominent coherence within a grand average coherogram were identified. A trend of a dopamine effect was observed for the first ROI (50-150 ms after movement start) with higher STN-EMG coherence in medicated patients. Concerning the second ROI (300-500 ms after movement start), an interaction effect of L-Dopa medication and movement task was observed with higher coherence in the isometric contraction task compared to alternating movements in the medication ON state, a pattern which was reversed in L-Dopa OFF. : L-Dopa medication may normalize functional connectivity between remote structures of the motor system with increased upper beta coherence reflecting a physiological restriction of the amount of information conveyed between remote structures. This may be necessary to maintain simple movements like isometric contraction. Our study adds dynamic properties to the complex interplay between STN spectral beta power and the nucleus' functional connectivity to remote structures of the motor system as a function of movement and dopaminergic state. This may help to identify markers of neuronal activity relevant for more individualized programming of DBS therapy.

摘要

纹状体多巴胺耗竭会破坏基底神经节功能并导致帕金森病(PD)。然而,基底神经节信号与运动控制之间多巴胺依赖性关系的病理生理学尚未完全明确。我们对帕金森病患者的丘脑底核(STN)局部场电位(LFP)和肌电图(EMG)进行同步记录,以研究多巴胺能状态和运动对基底神经节与下运动神经元之间长程β功能连接的影响。:对8名帕金森病患者进行了研究,这些患者在植入能够长期记录LFP的深部脑刺激(DBS)系统(Medtronic,ACTIVA PC + S)3个月后接受观察。我们在两种不同的运动范式(强直性腕伸展与交替性腕伸展和屈曲)背景下分析了STN频谱功率及其与EMG的相干性,以及左旋多巴(L - Dopa)摄入的影响,并采用无偏数据驱动方法确定感兴趣区域(ROI)。:在一个总体平均相干图中识别出两个捕获显著相干性的ROI。在第一个ROI(运动开始后50 - 150毫秒)观察到多巴胺效应的趋势,服药患者的STN - EMG相干性更高。关于第二个ROI(运动开始后300 - 500毫秒),观察到左旋多巴药物治疗和运动任务的交互作用,在服药状态下,与交替运动相比,等长收缩任务中的相干性更高,而在左旋多巴停药状态下这种模式则相反。:左旋多巴药物治疗可能使运动系统远程结构之间的功能连接正常化,增加的上β相干性反映了远程结构之间传递信息量的生理限制。这对于维持等长收缩等简单运动可能是必要的。我们的研究为STN频谱β功率与该核与运动系统远程结构的功能连接之间的复杂相互作用增添了动态特性,这是运动和多巴胺能状态的函数。这可能有助于识别与更个性化的DBS治疗编程相关的神经元活动标记物。

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