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丘脑底核刺激会损害正在进行的运动的停止。

Subthalamic stimulation impairs stopping of ongoing movements.

机构信息

Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Berlin Institute of Health (BIH), Berlin, Germany.

出版信息

Brain. 2021 Feb 12;144(1):44-52. doi: 10.1093/brain/awaa341.

Abstract

The subthalamic nucleus is part of a global stopping network that also includes the presupplementary motor area and inferior frontal gyrus of the right hemisphere. In Parkinson's disease, subthalamic deep brain stimulation improves movement initiation and velocity, but its effect on stopping of ongoing movement is unknown. Here, we examine the relation between movement stopping and connectivity of stimulation volumes to the stopping network. Stop and go times were collected in 17 patients with Parkinson's disease on and off subthalamic stimulation during visually cued initiation and termination of continuous, rotational movements. Deep brain stimulation contacts were localized; the stimulation volume computed and connectivity profiles estimated using an openly available, normative structural connectome. Subthalamic stimulation significantly increased stop times, which correlated with the connectivity of the stimulation volume to presupplementary motor area and inferior frontal gyrus of the right hemisphere. The robustness of this finding was validated using three separate analysis streams: voxel-wise whole-brain connectivity, region of interest connectivity and a tract-centred method. Our study sheds light on the role of the fronto-subthalamic inhibitory triangle in stopping of ongoing movements and may inspire circuit based adaptive stimulation strategies for control of stopping impairment, possibly reflected in stimulation-induced dyskinesia.

摘要

底丘脑核是全局停止网络的一部分,该网络还包括辅助运动区和右侧额下回。在帕金森病中,底丘脑深部脑刺激可改善运动起始和速度,但对正在进行的运动停止的影响尚不清楚。在这里,我们研究了运动停止与刺激体积与停止网络连接之间的关系。在视觉提示开始和结束连续旋转运动期间,我们在 17 名帕金森病患者的底丘脑刺激下和停止刺激下收集停止和继续时间。定位深部脑刺激触点;使用公开可用的规范结构连接体计算刺激体积并估计连通性概况。底丘脑刺激显著增加了停止时间,这与刺激体积与辅助运动区和右侧额下回的连通性相关。使用三个独立的分析流:全脑连通性的体素分析、感兴趣区域连通性和束中心方法,验证了该发现的稳健性。我们的研究揭示了额底丘脑抑制三角在停止进行中的运动中的作用,并可能激发基于回路的适应性刺激策略,以控制停止障碍,这可能反映在刺激诱导的运动障碍中。

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