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帕金森病中步态对皮质下局部场电位的影响及关系:一项系统评价

Effect and Relationship of Gait on Subcortical Local Field Potentials in Parkinson's Disease: A Systematic Review.

作者信息

Morelli Nathan

机构信息

Medtronic, Minneapolis, MN, USA.

出版信息

Neuromodulation. 2023 Feb;26(2):271-279. doi: 10.1016/j.neurom.2022.09.001. Epub 2022 Oct 14.

Abstract

OBJECTIVES

Developments in deep brain stimulation (DBS) technology have enabled the ability to detect local field potentials (LFPs) in Parkinson disease (PD). Gait dysfunction is one of the most prevalent deficits seen in PD. However, no consensus has been reached on the effect of gait on LFPs and the relationship between LFPs and clinical measures of gait. The objective of this systematic review was to synthesize existing research regarding the relationship between gait dysfunction and LFPs in PD.

METHODS

A systematic search of the literature yielded a total of ten articles, including 132 patients with PD, which met the criteria for inclusion.

RESULTS

Beta frequency band measures showed low-to-strong correlation to clinical gait measures (r = -0.50 to 0.82). Two studies found decreased beta power during gait; one found increased beta frequency peaks during gait; and one found higher beta power during dual-task gait than during single-task gait. One of the three studies comparing patients with and without freezing found significantly increased beta burst duration and power during gait in freezers compared with nonfreezers. All studies showed moderate-to-high methodologic quality.

CONCLUSIONS

This review highlights the need to consider the effect of gait on LFP recordings, particularly when used to guide DBS programming. Although sample sizes were small, it appears LFPs are associated to and modulated by gait in patients with PD. This evidence suggests that LFPs have the potential to be used as a biomarker of gait dysfunction in PD.

摘要

目的

深部脑刺激(DBS)技术的发展使得检测帕金森病(PD)中的局部场电位(LFP)成为可能。步态功能障碍是PD中最常见的缺陷之一。然而,关于步态对LFP的影响以及LFP与步态临床指标之间的关系尚未达成共识。本系统评价的目的是综合现有关于PD中步态功能障碍与LFP之间关系的研究。

方法

对文献进行系统检索,共获得10篇文章,包括132例符合纳入标准的PD患者。

结果

β频段测量结果与临床步态测量结果呈低到强的相关性(r = -0.50至0.82)。两项研究发现步态期间β功率降低;一项研究发现步态期间β频率峰值增加;一项研究发现双任务步态期间的β功率高于单任务步态期间。在比较有和没有冻结现象的患者的三项研究中,有一项发现与无冻结现象的患者相比,有冻结现象的患者在步态期间的β爆发持续时间和功率显著增加。所有研究均显示出中到高的方法学质量。

结论

本综述强调需要考虑步态对LFP记录的影响,特别是在用于指导DBS编程时。尽管样本量较小,但似乎LFP与PD患者的步态相关并受其调节。这一证据表明LFP有潜力用作PD中步态功能障碍的生物标志物。

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