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帕金森病患者短期多学科强化康复治疗的皮质反应特征:一项经颅磁刺激和脑电图研究。

Characterizing cortical responses to short-term multidisciplinary intensive rehabilitation treatment in patients with Parkinson's disease: A transcranial magnetic stimulation and electroencephalography study.

作者信息

Pei Guangying, Liu Xinting, Huang Qiwei, Shi Zhongyan, Wang Li, Suo Dingjie, Funahashi Shintaro, Wu Jinglong, Zhang Jian, Fang Boyan

机构信息

School of Life Science, Beijing Institute of Technology, Beijing, China.

Advanced Research Institute of Multidisciplinary Science, Beijing Institute of Technology, Beijing, China.

出版信息

Front Aging Neurosci. 2022 Nov 3;14:1045073. doi: 10.3389/fnagi.2022.1045073. eCollection 2022.

Abstract

Combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) is a powerful non-invasive tool for qualifying the neurophysiological effects of interventions by recording TMS-induced cortical activation with high temporal resolution and generates reproducible and reliable waves of activity without participant cooperation. Cortical dysfunction contributes to the pathogenesis of the clinical symptoms of Parkinson's disease (PD). Here, we examined changes in cortical activity in patients with PD following multidisciplinary intensive rehabilitation treatment (MIRT). Forty-eight patients with PD received 2 weeks of MIRT. The cortical response was examined following single-pulse TMS over the primary motor cortex by 64-channel EEG, and clinical symptoms were assessed before and after MIRT. TMS-evoked potentials were quantified by the global mean field power, as well as oscillatory power in theta, alpha, beta, and gamma bands, and their clinical correlations were calculated. After MIRT, motor and non-motor symptoms improved in 22 responders, and only non-motor function was enhanced in 26 non-responders. Primary motor cortex stimulation reduced global mean field power amplitudes in responders but not significantly in non-responders. Oscillations exhibited attenuated power in the theta, beta, and gamma bands in responders but only reduced gamma power in non-responders. Associations were observed between beta oscillations and motor function and between gamma oscillations and non-motor symptoms. Our results suggest that motor function enhancement by MIRT may be due to beta oscillatory power modulation and that alterations in cortical plasticity in the primary motor cortex contribute to PD recovery.

摘要

经颅磁刺激与脑电图联合技术(TMS-EEG)是一种强大的非侵入性工具,通过以高时间分辨率记录经颅磁刺激诱导的皮层激活来确定干预措施的神经生理效应,并且无需参与者配合就能产生可重复且可靠的活动波。皮层功能障碍是帕金森病(PD)临床症状发病机制的一个因素。在此,我们研究了多学科强化康复治疗(MIRT)后帕金森病患者皮层活动的变化。48例帕金森病患者接受了为期2周的MIRT。通过64导脑电图在初级运动皮层进行单脉冲经颅磁刺激后检测皮层反应,并在MIRT前后评估临床症状。经颅磁刺激诱发电位通过全局平均场功率以及θ、α、β和γ频段的振荡功率进行量化,并计算它们与临床症状的相关性。MIRT后,22例有反应者的运动和非运动症状有所改善,26例无反应者仅非运动功能得到增强。初级运动皮层刺激使有反应者的全局平均场功率振幅降低,但无反应者降低不明显。有反应者在θ、β和γ频段的振荡功率减弱,而无反应者仅γ功率降低。观察到β振荡与运动功能以及γ振荡与非运动症状之间存在关联。我们的结果表明,MIRT增强运动功能可能归因于β振荡功率调制,并且初级运动皮层的皮层可塑性改变有助于帕金森病的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b1e/9669794/2c1204e16ac9/fnagi-14-1045073-g001.jpg

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