Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom,
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
Stereotact Funct Neurosurg. 2020;98(3):193-199. doi: 10.1159/000507032. Epub 2020 Apr 29.
The subthalamic nucleus (STN) is a common target for deep brain stimulation (DBS) in Parkinson's disease (PD) and is believed to serve a role in sensorimotor integration. In addition to therapeutic neuromodulation, DBS facilitates the recording of local-field potentials (LFPs) in order to further understand the neurophysiological basis of disease. The capacity to wirelessly transmit these signals in real time has overcome the obstacle of externalization of electrodes during LFP recordings.
Using the G102RS device (PINS Medical, China), we investigated the LFP changes in response to mechanical pain stimulation to further elucidate the representation of pain sensation in the basal ganglia.
LFPs from 2 patients who had undergone bilateral STN-DBS were wirelessly recorded during no stimulation, low-frequency stimulation (60 and 90 Hz), and high-frequency stimulation (130 and 150 Hz) while introducing painful and nonpainful stimuli. Power spectral analysis was conducted to compare the changes in β frequency (13-30 Hz) during each stimulus.
During painful stimuli, STN power spectra (n = 4) revealed a significant increase in β activity compared to non-painful and no-stimulus epochs. Both low- and high-frequency stimulation produced a significant decrease in pain-related β activity.
These 2 cases have demonstrated the potential for acute noxious stimuli to exacerbate pathologic β oscillatory activity in the STN. Our findings represent novel evidence of the neurophysiologic representation of pain in the STN of PD patients.
丘脑底核(STN)是帕金森病(PD)深部脑刺激(DBS)的常见靶点,被认为在感觉运动整合中起作用。除了治疗性神经调节外,DBS 还促进了局部场电位(LFPs)的记录,以便进一步了解疾病的神经生理基础。无线实时传输这些信号的能力克服了在 LFPs 记录期间电极外化的障碍。
使用 G102RS 设备(PINS Medical,中国),我们研究了机械疼痛刺激反应中的 LFPs 变化,以进一步阐明基底神经节中疼痛感觉的表示。
对接受双侧 STN-DBS 的 2 名患者的 LFPs 在无刺激、低频刺激(60 和 90 Hz)和高频刺激(130 和 150 Hz)期间进行无线记录,同时引入疼痛和非疼痛刺激。进行功率谱分析以比较每个刺激期间β频率(13-30 Hz)的变化。
在疼痛刺激期间,与非疼痛和无刺激时段相比,STN 功率谱(n = 4)显示β活动显著增加。低和高频刺激均导致与疼痛相关的β活动显著降低。
这 2 个病例表明急性有害刺激有可能加剧 PD 患者 STN 中的病理性β振荡活动。我们的发现代表了 PD 患者 STN 中疼痛神经生理表示的新证据。