Luo Bei, Lu Yue, Qiu Chang, Dong Wenwen, Xue Chen, Liu Dongming, Zhang Li, Liu Weiguo, Zhang Wenbin
Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
Parkinsons Dis. 2021 Sep 1;2021:2711365. doi: 10.1155/2021/2711365. eCollection 2021.
Patients with Parkinson's disease (PD) undergoing deep brain electrode implantation experience a temporary improvement in motor symptoms before the electrical stimulation begins. We usually call this the microlesion effect (MLE), but the mechanism behind it is not clear.
This study aimed to assess the alterations in brain functions at the regional and whole-brain levels, using regional homogeneity (ReHo) and functional connectivity (FC), during the postoperative microlesion period after deep brain stimulation (DBS) in PD patients.
Resting-state functional MRI data were collected from 27 PD patients before and after the first day of DBS and 12 healthy controls (HCs) in this study. The ReHo in combination with FC analysis was used to investigate the alterations of regional brain activity in all the subjects.
There were increased ReHo in the basal ganglia-thalamocortical circuit (left supplementary motor area and bilateral paracentral lobule), whereas decreased ReHo in the default mode network (DMN) (left angular gyrus, bilateral precuneus), prefrontal cortex (bilateral middle frontal gyrus), and the cerebello-thalamocortical (CTC) circuit (Cerebellum_crus2/1_L) after DBS. In addition, we also found abnormal FC in the lingual gyrus, cerebellum, and DMN.
Microlesion of the thalamus caused by electrode implantation can alter the activity of the basal ganglia-thalamocortical circuit, prefrontal cortex, DMN, and CTC circuit and induce abnormal FC in the lingual gyrus, cerebellum, prefrontal cortex, and DMN among PD patients. The findings of this study contribute to the understanding of the mechanism of MLE.
接受脑深部电极植入的帕金森病（PD）患者在电刺激开始前运动症状会有短暂改善。我们通常称此为微损伤效应（MLE），但其背后的机制尚不清楚。
本研究旨在利用局部一致性（ReHo）和功能连接（FC）评估PD患者脑深部刺激（DBS）术后微损伤期区域和全脑水平的脑功能变化。
本研究收集了27例PD患者在DBS第一天前后以及12名健康对照者（HCs）的静息态功能磁共振成像数据。采用ReHo结合FC分析来研究所有受试者脑区活动的变化。
DBS后，基底神经节 - 丘脑皮质回路（左侧辅助运动区和双侧中央旁小叶）的ReHo增加，而默认模式网络（DMN）（左侧角回、双侧楔前叶）、前额叶皮质（双侧额中回）和小脑 - 丘脑皮质（CTC）回路（小脑_ Crus2/1_L）的ReHo降低。此外，我们还发现舌回、小脑和DMN存在异常FC。
电极植入引起的丘脑微损伤可改变基底神经节 - 丘脑皮质回路、前额叶皮质、DMN和CTC回路的活动，并在PD患者的舌回、小脑、前额叶皮质和DMN中诱导异常FC。本研究结果有助于理解MLE的机制。
