Department of Neurology, National Taiwan University Hospital, No. 7, Jhongshan South Road, 100225, Taipei, Taiwan.
Neurosci Biobehav Rev. 2022 Jan;132:410-419. doi: 10.1016/j.neubiorev.2021.11.044. Epub 2021 Nov 29.
Understanding the pathophysiological mechanism of Parkinson's disease (PD) in the subthalamic nucleus (STN) has become a critical issue since deep brain stimulation (DBS) in this region has been proven as an effective treatment for this disease. The STN possesses a special ability to switch from the spike to the burst firing mode in response to dopamine deficiency in parkinsonism, and this STN burst is considered an electrophysiological signature of the cortico-basal ganglia circuit in the brains of PD patients. This review focuses on the role of STN burst firing in the pathophysiology of PD and during DBS. Here, we review existing literature on how STN bursts originate and the specific factors affecting their formation; how STN burst firing causes motor symptoms in PD and how interventions can rescue these symptoms. Finally, the similarities and differences between the two electrophysiological hallmarks of PD, STN burst firing and beta-oscillation, are discussed. STN burst firing should be considered as a pathophysiological target in PD during treatment with DBS.
了解帕金森病（PD）在丘脑底核（STN）中的病理生理机制已成为一个关键问题，因为该区域的深部脑刺激（DBS）已被证明是治疗这种疾病的有效方法。STN 具有一种特殊的能力，即在帕金森病中对多巴胺缺乏作出反应时，从尖峰放电模式切换到爆发放电模式，而这种 STN 爆发被认为是 PD 患者大脑中皮质基底节回路的电生理特征。本综述重点关注 STN 爆发在 PD 的病理生理学和 DBS 中的作用。在这里，我们回顾了关于 STN 爆发起源以及影响其形成的特定因素的现有文献；STN 爆发放电如何引起 PD 中的运动症状，以及干预措施如何挽救这些症状。最后，讨论了 PD 的两个电生理特征，即 STN 爆发和β振荡之间的异同。在 DBS 治疗期间，STN 爆发应被视为 PD 的病理生理靶点。
