帕金森病深部脑刺激时的身体运动的频谱分析。

Spectral analysis of body movement during deep brain stimulation in Parkinson's disease.

机构信息

Department of Brain Sciences, Imperial College London, W6 8RF London, UK; Faculty of Science and Engineering, School of Medicine & Clinical Practice, University of Wolverhampton, Wolverhampton, WV1 1LY, UK.

Department of Health Sciences, Lund University, S-221 85 Lund, Sweden; Memory Clinic, Skåne University Hospital, S-212 24 Malmö, Sweden; Clinical Memory Research Unit, Faculty of Medicine, Lund University, S-221 85 Lund, Sweden.

出版信息

Gait Posture. 2021 May;86:217-225. doi: 10.1016/j.gaitpost.2021.03.023. Epub 2021 Mar 18.

DOI:10.1016/j.gaitpost.2021.03.023

PMID:33765547

Abstract

BACKGROUND

The characteristics of Parkinson's disease (PD) include postural instability and resting tremor. However, reductions of tremor amplitude do not always improve postural stability.

RESEARCH QUESTION

What is the effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on spectral analysis of body movement in patients with PD when tested without anti-PD medication? The effect of visual cues was also studied.

METHODS

Ten patients with PD (mean age 64.3 years, range 59-69 years) and 17 control participants (mean age 71.2 years, range 65-79 years) were recruited. Spectral power following a period of quiet stance (35 s) was analysed in three different spectral power bands (0-4 Hz, 4-7 Hz and 7-25 Hz). Motion markers were secured to the head, shoulder, hip, and knee, which recorded movements in two directions, the anteroposterior and lateral.

RESULTS

DBS STN significantly changed the spectral distribution pattern across the body in the anteroposterior (p = 0.029) and lateral directions (p ≤ 0.003). DBS predominantly reduced spectral power at the head (p ≤ 0.037) and shoulder (p ≤ 0.031) in the lateral direction. The spectral power of the lower and upper body in patients with PD, with DBS ON, were more similar to the control group, than to DBS OFF. Visual cues mainly reduced spectral power in the anteroposterior direction at the shoulder (p ≤ 0.041) in controls and in patients with PD with DBS ON.

SIGNIFICANCE

There is an altered postural strategy in patients with PD with DBS ON as shown by an altered spectral power distribution pattern across body segments and a reduction of spectral power in the lateral direction at the head and shoulder. A reduction of spectral power in controls and in patients with PD with DBS ON suggests that visual cues are able to reduce spectral power to some extent, but not with DBS OFF where postural sway and power are larger.

摘要

背景

帕金森病（PD）的特征包括姿势不稳和静止性震颤。然而，震颤幅度的降低并不总是能改善姿势稳定性。

研究问题

在不使用抗 PD 药物测试时，深部脑刺激（DBS）对 STN 对 PD 患者身体运动的频谱分析有什么影响？还研究了视觉提示的效果。

方法

招募了 10 名 PD 患者（平均年龄 64.3 岁，范围 59-69 岁）和 17 名对照参与者（平均年龄 71.2 岁，范围 65-79 岁）。在安静站立 35s 后，对三个不同的频谱功率带（0-4Hz、4-7Hz 和 7-25Hz）进行了频谱功率分析。头部、肩部、臀部和膝盖上固定了运动标记，记录了两个方向（前后和左右）的运动。

结果

DBS STN 显著改变了前后（p=0.029）和左右（p≤0.003）方向上的身体频谱分布模式。DBS 主要降低了左右方向头部（p≤0.037）和肩部（p≤0.031）的频谱功率。DBS 开启时，PD 患者的上下身频谱功率与对照组相比，更接近对照组，而不是 DBS 关闭时。视觉提示主要降低了对照组和 DBS 开启时 PD 患者的肩部前后方向的频谱功率（p≤0.041）。