Department of Electrical Engineering and Computer Science, University of California, Irvine, CA, USA.
Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
Sci Rep. 2021 Apr 19;11(1):8498. doi: 10.1038/s41598-021-88114-w.
High-frequency peripheral nerve stimulation has emerged as a noninvasive alternative to thalamic deep brain stimulation for some patients with essential tremor. It is not known whether such techniques might be effective for movement disorders in children, nor is the mechanism and transmission of the peripheral stimuli to central brain structures understood. This study was designed to investigate the fidelity of transmission from peripheral nerves to thalamic nuclei in children with dystonia undergoing deep brain stimulation surgery. The ventralis intermediate (VIM) thalamus nuclei showed a robust evoked response to peripheral high-frequency burst stimulation, with a greatest response magnitude to intra-burst frequencies between 50 and 100 Hz, and reliable but smaller responses up to 170 Hz. The earliest response occurred at 12-15 ms following stimulation onset, suggesting rapid high-fidelity transmission between peripheral nerve and thalamic nuclei. A high-bandwidth, low-latency transmission path from peripheral nerve to VIM thalamus is consistent with the importance of rapid and accurate sensory information for the control of coordination and movement via the cerebello-thalamo-cortical pathway. Our results suggest the possibility of non-invasive modulation of thalamic activity in children with dystonia, and therefore the possibility that a subset of children could have beneficial clinical response without the need for invasive deep brain stimulation.
高频外周神经刺激已成为治疗原发性震颤患者的丘脑深部脑刺激的一种非侵入性替代方法。目前尚不清楚这些技术是否对儿童的运动障碍有效，也不了解外周刺激向中枢脑结构的传递机制。本研究旨在探讨接受深部脑刺激手术的脑瘫患儿外周神经向丘脑核传递的保真度。腹侧中间（VIM）丘脑核对周围高频爆发刺激显示出强大的诱发电位反应，在 50-100Hz 之间的爆发内频率下反应幅度最大，在 170Hz 下可靠但较小。最早的反应发生在刺激开始后 12-15ms，表明外周神经和丘脑核之间存在快速、高保真的传输。从外周神经到 VIM 丘脑的高带宽、低延迟传输路径与通过小脑-丘脑-皮质通路对协调和运动进行快速准确的感觉信息控制的重要性一致。我们的研究结果表明，有可能对脑瘫患儿的丘脑活动进行非侵入性调节，因此有可能使一部分患儿无需进行侵入性深部脑刺激就能获得有益的临床反应。
