de Hemptinne Coralie, Chen Witney, Racine Caroline A, Seritan Andreea L, Miller Andrew M, Yaroshinsky Maria S, Wang Sarah S, Gilron Roee, Little Simon, Bledsoe Ian, San Luciano Marta, Katz Maya, Chang Edward F, Dawes Heather E, Ostrem Jill L, Starr Philip A
Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States.
Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States.
Front Neurosci. 2021 Oct 21;15:748165. doi: 10.3389/fnins.2021.748165. eCollection 2021.
Anxiety and depression are prominent non-motor symptoms of Parkinson's disease (PD), but their pathophysiology remains unclear. We sought to understand their neurophysiological correlates from chronic invasive recordings of the prefrontal cortex (PFC). We studied four patients undergoing deep brain stimulation (DBS) for their motor signs, who had comorbid mild to moderate anxiety and/or depressive symptoms. In addition to their basal ganglia leads, we placed a permanent prefrontal subdural 4-contact lead. These electrodes were attached to an investigational pulse generator with the capability to sense and store field potential signals, as well as deliver therapeutic neurostimulation. At regular intervals over 3-5 months, participants paired brief invasive neural recordings with self-ratings of symptoms related to depression and anxiety. Mean age was 61 ± 7 years, mean disease duration was 11 ± 8 years and a mean Unified Parkinson's Disease Rating Scale, with part III (UPDRS-III) off medication score of 37 ± 13. Mean Beck Depression Inventory (BDI) score was 14 ± 5 and Beck Anxiety Index was 16.5 ± 5. Prefrontal cortex spectral power in the beta band correlated with patient self-ratings of symptoms of depression and anxiety, with -values between 0.31 and 0.48. Mood scores showed negative correlation with beta spectral power in lateral locations, and positive correlation with beta spectral power in a mesial recording location, consistent with the dichotomous organization of reward networks in PFC. These findings suggest a physiological basis for anxiety and depression in PD, which may be useful in the development of neurostimulation paradigms for these non-motor disease features.
焦虑和抑郁是帕金森病（PD）突出的非运动症状，但其病理生理学仍不清楚。我们试图通过对前额叶皮层（PFC）进行慢性侵入性记录来了解它们的神经生理学关联。我们研究了4名因运动症状接受深部脑刺激（DBS）治疗且伴有轻度至中度焦虑和/或抑郁症状的患者。除了在基底神经节植入电极外，我们还在前额叶放置了一个永久性的硬膜下四触点电极。这些电极连接到一个研究性脉冲发生器上，该发生器能够感知和存储场电位信号，并进行治疗性神经刺激。在3至5个月的时间里，参与者定期将短暂的侵入性神经记录与抑郁和焦虑相关症状的自我评分配对。平均年龄为61±7岁，平均病程为11±8年，平均帕金森病统一评分量表第三部分（UPDRS-III）非药物状态下的评分为37±13。贝克抑郁量表（BDI）平均得分为14±5，贝克焦虑指数为16.5±5。前额叶皮层β波段的频谱功率与患者抑郁和焦虑症状的自我评分相关，相关系数在0.31至0.48之间。情绪评分与外侧位置的β频谱功率呈负相关，与内侧记录位置的β频谱功率呈正相关，这与前额叶皮层奖励网络的二分组织一致。这些发现为帕金森病中焦虑和抑郁提供了生理基础，这可能有助于开发针对这些非运动疾病特征的神经刺激模式。
