Miyawaki Edison K
Department of Neurology, Mass General Brigham, Boston, MA, United States.
Harvard Medical School, Boston, MA, United States.
Front Neurol. 2022 Jul 8;13:927160. doi: 10.3389/fneur.2022.927160. eCollection 2022.
The association between idiopathic Parkinson's disease, a paradigmatic dopamine-deficiency syndrome, and problems in the estimation of time has been studied experimentally for decades. I review that literature, which raises a question about whether and if dopamine deficiency relates not only to the motor slowness that is an objective and cardinal parkinsonian sign, but also to a compromised neural substrate for time perception. Why does a clinically (motorically) significant deficiency in dopamine play a role in the subjective perception of time's passage? After a discussion of a classical conception of basal ganglionic control of movement under the influence of dopamine, I describe recent work in healthy mice using optogenetics; the methodology visualizes dopaminergic neuronal firing in very short time intervals, then allows for correlation with motor behaviors in trained tasks. Moment-to-moment neuronal activity is both highly dynamic and variable, as assessed by photometry of genetically defined dopaminergic neurons. I use those animal data as context to review a large experimental experience in humans, spanning decades, that has examined subjective time perception mainly in Parkinson's disease, but also in other movement disorders. Although the human data are mixed in their findings, I argue that loss of dynamic variability in dopaminergic neuronal activity over very short intervals may be a fundamental aspect in the pathophysiology of parkinsonism. An important implication is that therapeutic response in Parkinson's disease needs to be understood in terms of short-term alterations in dynamic neuronal firing, as has already been examined in novel ways-for example, in the study of real-time changes in neuronal network oscillations across very short time intervals. A finer analysis of a treatment's network effects might aid in any effort to augment clinical response to either medications or functional neurosurgical interventions in Parkinson's disease.
特发性帕金森病是一种典型的多巴胺缺乏综合征,几十年来,人们一直在通过实验研究它与时间估计问题之间的关联。我回顾了相关文献,这些文献提出了一个问题:多巴胺缺乏是否不仅与帕金森病的客观主要体征——运动迟缓有关,还与时间感知的神经基质受损有关。为什么临床上(运动方面)显著的多巴胺缺乏会在对时间流逝的主观感知中起作用?在讨论了多巴胺影响下基底神经节对运动控制的经典概念后,我描述了近期在健康小鼠中使用光遗传学的研究工作;该方法可以在非常短的时间间隔内可视化多巴胺能神经元的放电,然后将其与训练任务中的运动行为进行关联。通过对基因定义的多巴胺能神经元进行光度测定评估,瞬间神经元活动既高度动态又具有变异性。我以这些动物数据为背景,回顾了几十年来在人类身上进行的大量实验经验,这些研究主要考察了帕金森病患者的主观时间感知,但也涉及其他运动障碍患者。尽管人类研究的数据结果不一,但我认为在非常短的时间间隔内多巴胺能神经元活动丧失动态变异性可能是帕金森病病理生理学的一个基本方面。一个重要的启示是,帕金森病的治疗反应需要从动态神经元放电的短期变化角度来理解,就像已经以新的方式进行研究的那样——例如,在研究非常短的时间间隔内神经网络振荡的实时变化时。对治疗的网络效应进行更精细的分析可能有助于增强帕金森病患者对药物或功能性神经外科干预的临床反应。