帕金森病中运动皮质促进-抑制性回路相互作用受损。
Impaired motor cortical facilitatory-inhibitory circuit interaction in Parkinson's disease.
作者信息
Saravanamuttu James, Radhu Natasha, Udupa Kaviraja, Baarbé Julianne, Gunraj Carolyn, Chen Robert
机构信息
Division of Neurology, Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour - Systems Neuroscience, Krembil Brain Institute, University Health Network, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.
Division of Neurology, Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour - Systems Neuroscience, Krembil Brain Institute, University Health Network, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada; Department of Neurophysiology, National Institute of Mental Health and NeuroSciences, Hosur Road, Bangalore, India.
出版信息
Clin Neurophysiol. 2021 Oct;132(10):2685-2692. doi: 10.1016/j.clinph.2021.05.032. Epub 2021 Jul 6.
OBJECTIVE
Motor cortical (M1) inhibition and facilitation can be studied with short-interval intracortical inhibition (SICI) and short-interval intracortical facilitation (SICF). These circuits are altered in Parkinson's disease (PD). The sensorimotor measure short latency afferent inhibition (SAI) is possibly altered in PD. The aim was to determine if the manner in which these circuits interact with each other is abnormal in PD.
METHODS
Fifteen PD patients were studied at rest in ON and OFF medication states, and were compared to 16 age-matched controls. A triple-stimulus transcranial magnetic stimulation paradigm was used to elicit a circuit of interest in the presence of another circuit.
RESULTS
SICF was increased in PD OFF and PD ON conditions compared to controls. SICI facilitated SICF in controls and PD ON, but not in PD OFF. SICF in the presence of SICI negatively correlated with UPDRS-III scores in OFF and ON medication conditions. SAI showed similar inhibition of SICI in controls, PD OFF and PD ON conditions.
CONCLUSIONS
The facilitatory effect of SICI on SICF is absent in PD OFF, but is restored with dopaminergic medication.
SIGNIFICANCE
Impaired interaction between M1 circuits is a pathophysiological feature of PD.
目的
运动皮层（M1）抑制和易化作用可通过短间隔皮层内抑制（SICI）和短间隔皮层内易化（SICF）进行研究。这些神经回路在帕金森病（PD）中会发生改变。感觉运动测量指标短潜伏期传入抑制（SAI）在PD中可能也会发生改变。本研究旨在确定这些神经回路在PD中彼此之间的相互作用方式是否异常。
方法
对15例PD患者在服药和未服药状态下静息时进行研究，并与16例年龄匹配的对照组进行比较。采用三刺激经颅磁刺激范式，在存在另一个神经回路的情况下引发感兴趣的神经回路。
结果
与对照组相比，PD未服药和服药状态下SICF均增加。在对照组和PD服药状态下，SICI促进SICF，但在PD未服药状态下则不然。在未服药和服药状态下，存在SICI时的SICF与统一帕金森病评定量表第三部分（UPDRS-III）评分呈负相关。在对照组、PD未服药和服药状态下，SAI对SICI的抑制作用相似。
结论
PD未服药状态下SICI对SICF的促进作用消失，但多巴胺能药物治疗后可恢复。
意义
M1神经回路之间的相互作用受损是PD的病理生理特征。
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