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帕金森病中前庭运动感知与丘脑底核深部脑刺激所激发的轴突通路是否相关?

Does Vestibular Motion Perception Correlate with Axonal Pathways Stimulated by Subthalamic Deep Brain Stimulation in Parkinson's Disease?

作者信息

Beylergil Sinem Balta, Noecker Angela M, Kilbane Camilla, McIntyre Cameron C, Shaikh Aasef G

机构信息

Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.

National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.

出版信息

Cerebellum. 2024 Apr;23(2):554-569. doi: 10.1007/s12311-023-01576-8. Epub 2023 Jun 13.

Abstract

Perception of our linear motion - heading - is critical for postural control, gait, and locomotion, and it is impaired in Parkinson's disease (PD). Deep brain stimulation (DBS) has variable effects on vestibular heading perception, depending on the location of the electrodes within the subthalamic nucleus (STN). Here, we aimed to find the anatomical correlates of heading perception in PD. Fourteen PD participants with bilateral STN DBS performed a two-alternative forced-choice discrimination task where a motion platform delivered translational forward movements with a heading angle varying between 0 and 30° to the left or to the right with respect to the straight-ahead direction. Using psychometric curves, we derived the heading discrimination threshold angle of each patient from the response data. We created patient-specific DBS models and calculated the percentages of stimulated axonal pathways that are anatomically adjacent to the STN and known to play a major role in vestibular information processing. We performed correlation analyses to investigate the extent of these white matter tracts' involvement in heading perception. Significant positive correlations were identified between improved heading discrimination for rightward heading and the percentage of activated streamlines of the contralateral hyperdirect, pallido-subthalamic, and subthalamo-pallidal pathways. The hyperdirect pathways are thought to provide top-down control over STN connections to the cerebellum. In addition, STN may also antidromically activate collaterals of hyperdirect pathway that projects to the precerebellar pontine nuclei. In select cases, there was strong activation of the cerebello-thalamic projections, but it was not consistently present in all participants. Large volumetric overlap between the volume of tissue activation and the STN in the left hemisphere positively impacted rightward heading perception. Altogether, the results suggest heavy involvement of basal ganglia cerebellar network in STN-induced modulation of vestibular heading perception in PD.

摘要

对我们直线运动方向的感知对于姿势控制、步态和移动至关重要,而在帕金森病(PD)中这种感知会受损。深部脑刺激(DBS)对前庭方向感知有不同影响,这取决于电极在丘脑底核(STN)内的位置。在此,我们旨在找出PD中方向感知的解剖学关联。14名接受双侧STN DBS的PD参与者进行了二选一强制选择辨别任务,在该任务中,一个运动平台向前进行平移运动,相对于正前方方向,其航向角在0至30°之间向左或向右变化。利用心理测量曲线,我们从反应数据中得出每位患者的方向辨别阈值角。我们创建了患者特异性的DBS模型,并计算了在解剖学上与STN相邻且已知在前庭信息处理中起主要作用的受刺激轴突通路的百分比。我们进行了相关性分析,以研究这些白质束在方向感知中的参与程度。在向右方向的方向辨别改善与对侧超直接、苍白球 - 丘脑底核和丘脑底核 - 苍白球通路的激活流线百分比之间发现了显著的正相关。超直接通路被认为对STN与小脑的连接提供自上而下的控制。此外,STN也可能逆向激活投射到脑桥前小脑核的超直接通路的侧支。在某些情况下,小脑 - 丘脑投射有强烈激活,但并非在所有参与者中都始终存在。左半球组织激活体积与STN之间的大量体积重叠对向右方向感知有积极影响。总体而言,结果表明基底神经节 - 小脑网络在STN诱导的PD前庭方向感知调节中起重要作用。

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