Department of Physical Therapy and Human Movement Sciences, Northwestern University, 645 North Michigan Avenue, Suite 1100, Chicago, IL, 60611, USA.
Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
Exp Brain Res. 2020 Aug;238(7-8):1659-1676. doi: 10.1007/s00221-020-05834-7. Epub 2020 Jun 3.
In this review, we highlight Professor John Rothwell's contribution towards understanding basal ganglia function and dysfunction, as well as the effects of subthalamic nucleus deep brain stimulation (STN DBS). The first section summarizes the rate and oscillatory models of basal ganglia dysfunction with a focus on the oscillation model. The second section summarizes the motor, gait, and cognitive mechanisms of action of STN DBS. In the final section, we summarize the effects of STN DBS on motor and cognitive tasks. The studies reviewed in this section support the conclusion that high-frequency STN DBS improves the motor symptoms of Parkinson's disease. With respect to cognition, STN DBS can be detrimental to performance especially when the task is cognitively demanding. Consolidating findings from many studies, we find that while motor network oscillatory activity is primarily correlated to the beta-band, cognitive network oscillatory activity is not confined to one band but is subserved by activity in multiple frequency bands. Because of these findings, we propose a modified motor and associative/cognitive oscillatory model that can explain the consistent positive motor benefits and the negative and null cognitive effects of STN DBS. This is clinically relevant because STN DBS should enhance oscillatory activity that is related to both motor and cognitive networks to improve both motor and cognitive performance.
在这篇综述中，我们强调了 John Rothwell 教授在理解基底神经节功能和功能障碍以及丘脑底核深部脑刺激（STN DBS）的影响方面的贡献。第一节总结了基底神经节功能障碍的速率和振荡模型，重点介绍了振荡模型。第二节总结了 STN DBS 的运动、步态和认知作用机制。在最后一节中，我们总结了 STN DBS 对运动和认知任务的影响。本节中回顾的研究支持以下结论：高频 STN DBS 可改善帕金森病的运动症状。关于认知，STN DBS 可能会对认知任务的表现产生不利影响，尤其是当任务具有认知挑战性时。综合多项研究的结果，我们发现，虽然运动网络的振荡活动主要与β波段相关，但认知网络的振荡活动并不局限于一个波段，而是由多个频带的活动所支持。基于这些发现，我们提出了一个改进的运动和联想/认知振荡模型，可以解释 STN DBS 的一致的积极运动益处以及负面和无效的认知效应。这在临床上是相关的，因为 STN DBS 应该增强与运动和认知网络都相关的振荡活动，以改善运动和认知表现。
