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电生理特征与脑深部电刺激撤除及植入效应的预测

Electrophysiological Signature and the Prediction of Deep Brain Stimulation Withdrawal and Insertion Effects.

作者信息

Trenado Carlos, Cif Laura, Pedroarena-Leal Nicole, Ruge Diane

机构信息

Laboratoire de Recherche en Neurosciences Cliniques, LRENC, Montpellier, France.

Département de Neurochirurgie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.

出版信息

Front Neurol. 2021 Nov 30;12:754701. doi: 10.3389/fneur.2021.754701. eCollection 2021.

Abstract

Deep brain stimulation (DBS) serves as a treatment for neurological and psychiatric disorders, such as Parkinson's disease (PD), essential tremor, dystonia, Tourette Syndrome (GTS), Huntington's disease, and obsessive-compulsive disorder (OCD). There is broad experience with the short-term effects of DBS in individual diseases and their signs/symptoms. However, even in acute treatment and for the same disorder or a given disorder, a prediction of effect is not perfect. Even further, the factors that influence the long-term effect of DBS and its withdrawal are hardly characterized. In this work, we aim to shed light on an important topic, the question of "DBS dependency." To address this, we make use of the Kuramoto model of phase synchronization (oscillation feature) endowed with neuroplasticity to study the effects of DBS under successive withdrawals and renewals of neuromodulation as well as influence of treatment duration in DBS "patients." The results of our simulation show that the characteristics of neuroplasticity have a profound effect on the stability and mutability of oscillation synchronization patterns across successive withdrawal and renewal of DBS in chronic "patients" and also in DBS "patients" with varying duration of treatment (here referred to as the "number of iterations"). Importantly, the results demonstrate the strong effect of the individual neuroplasticity makeup on the behavior of synchrony of oscillatory activity that promotes certain disorder/disease states or symptoms. The effect of DBS-mediated neuromodulation and withdrawal is highly dependent on the makeup of the neuroplastic signature of a disorder or an individual.

摘要

深部脑刺激(DBS)可用于治疗神经和精神疾病,如帕金森病(PD)、特发性震颤、肌张力障碍、图雷特综合征(GTS)、亨廷顿舞蹈症和强迫症(OCD)。对于DBS在个体疾病及其体征/症状方面的短期效果,已有广泛的经验。然而,即使在急性治疗中,对于同一种疾病或特定疾病,效果预测也并不完美。更进一步说,影响DBS长期效果及其撤停的因素几乎未得到明确。在这项研究中,我们旨在阐明一个重要的主题,即“DBS依赖性”问题。为了解决这个问题,我们利用具有神经可塑性的Kuramoto相位同步模型(振荡特征)来研究在神经调节的连续撤停和恢复以及治疗持续时间对DBS“患者”的影响。我们的模拟结果表明,神经可塑性特征对慢性“患者”以及不同治疗持续时间(这里称为“迭代次数”)的DBS“患者”在DBS连续撤停和恢复过程中振荡同步模式的稳定性和可变性具有深远影响。重要的是,结果表明个体神经可塑性构成对促进某些疾病/病症状态或症状的振荡活动同步行为具有强烈影响。DBS介导的神经调节和撤停效果高度依赖于疾病或个体的神经可塑性特征构成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e208/8669963/3506028b9133/fneur-12-754701-g0001.jpg

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