ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.
Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Mov Disord. 2023 Aug;38(8):1549-1554. doi: 10.1002/mds.29455. Epub 2023 May 25.
Gait freezing is a common, disabling symptom of Parkinson's disease characterized by sudden motor arrest during walking. Adaptive deep brain stimulation devices that detect freezing and deliver real-time, symptom-specific stimulation are a potential treatment strategy. Real-time alterations in subthalamic nucleus firing patterns have been demonstrated with lower limb freezing, however, whether similar abnormal signatures occur with freezing provoked by cognitive load, is unknown.
We obtained subthalamic nucleus microelectrode recordings from eight Parkinson's disease patients performing a validated virtual reality gait task, requiring responses to on-screen cognitive cues while maintaining motor output.
Signal analysis during 15 trials containing freezing or significant motor output slowing precipitated by dual-tasking demonstrated reduced θ frequency (3-8 Hz) firing compared to 18 unaffected trials.
These preliminary results reveal a potential neurobiological basis for the interplay between cognitive factors and gait disturbances including freezing in Parkinson's disease, informing development of adaptive deep brain stimulation protocols. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
步态冻结是帕金森病的一种常见致残症状，其特征是在行走过程中突然出现运动停止。能够检测到冻结并实时提供针对症状的刺激的适应性深部脑刺激设备是一种潜在的治疗策略。已经证明下肢冻结会导致丘脑底核放电模式的实时改变，但是否会出现类似的异常特征，目前尚不清楚。
我们从 8 名帕金森病患者中获得了丘脑底核微电极记录，这些患者正在进行一项经过验证的虚拟现实步态任务，需要对屏幕上的认知提示做出反应，同时保持运动输出。
在包含冻结或因双重任务而导致显著运动输出减慢的 15 次试验中，与 18 次不受影响的试验相比，θ 频率（3-8 Hz）放电减少。
这些初步结果揭示了认知因素与步态障碍（包括帕金森病中的冻结）之间相互作用的潜在神经生物学基础，为适应性深部脑刺激方案的发展提供了信息。© 2023 作者。运动障碍由 Wiley 期刊有限责任公司代表国际帕金森病和运动障碍学会出版。
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