帕金森病患者深部脑刺激前后的睡眠脑电图不对称性。
Sleep electroencephalographic asymmetry in Parkinson's disease patients before and after deep brain stimulation.
机构信息
Child Development Centre, University Children's Hospital, Zürich, Switzerland; Department of Health Sciences and Technology, ETH Zürich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zürich, Zürich, Switzerland.
Department of Neurology, University Hospital Zürich, University of Zürich, Zürich, Switzerland; Center of Competence Sleep & Health Zurich, University of Zürich, Zürich, Switzerland.
出版信息
Clin Neurophysiol. 2021 Apr;132(4):857-863. doi: 10.1016/j.clinph.2020.12.027. Epub 2021 Feb 5.
OBJECTIVE
Unilateral manifestation of motor dysfunction is a prominent hallmark of Parkinson's disease (PD). We investigated how the motor laterality of the disorder affects sleep neural asymmetry before and after Deep Brain Stimulation (DBS).
METHODS
Twenty-seven PD patients of the akinetic-rigid subtype were studied; 11 with right dominant (RD) and 16 with left dominant (LD) motor symptoms. Neuronal sleep asymmetry was computed as the difference of sleep slow-wave energy (SWE) between left and right hemispheres. We used linear mixed models to assess the relationship between symptomatic profile and SWE asymmetry.
RESULTS
LD PD patients exhibited frontal electroencephalographic (EEG) asymmetry and motor laterality pre-DBS with increased SWE contralateral to their affected body side, which diminished post-DBS. The RD group did not exhibit neither neural asymmetry nor motor laterality pre- and post-DBS. There was a significant negative correlation between the motor laterality and sleep EEG asymmetry.
CONCLUSIONS
Our results suggest evidence for a local use-dependent modulation of SWE as a result of the lateralized pathological motor profile. More bilateral motor symptoms and optimized treatment contribute to diminished sleep EEG asymmetry.
SIGNIFICANCE
These novel findings about the association between symptomatic motor laterality and sleep neural asymmetry may provide targeted therapeutic insights.
目的
运动功能障碍的单侧表现是帕金森病（PD）的一个突出标志。我们研究了疾病的运动偏侧性如何影响深部脑刺激（DBS）前后的睡眠神经不对称。
方法
研究了 27 名运动不能僵硬型 PD 患者，其中 11 名右侧优势（RD），16 名左侧优势（LD）运动症状。通过计算左、右半球之间的睡眠慢波能量（SWE）差异来计算神经元睡眠不对称性。我们使用线性混合模型来评估症状特征与 SWE 不对称性之间的关系。
结果
LD PD 患者在 DBS 前表现出额部脑电图（EEG）不对称和运动偏侧性，与受影响身体侧相反的 SWE 增加，DBS 后减少。RD 组在 DBS 前后均未出现神经不对称和运动偏侧性。运动偏侧性与睡眠 EEG 不对称之间存在显著负相关。
结论
我们的结果表明，由于偏侧性病理运动模式，SWE 存在局部依赖于使用的调制。更多的双侧运动症状和优化的治疗有助于减少睡眠 EEG 不对称。
意义
这些关于症状运动偏侧性与睡眠神经不对称之间关联的新发现可能为有针对性的治疗提供思路。
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