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低β频段抑制作为帕金森病运动不能-强直症状脑深部电刺激触点选择的工具。

Low beta-band suppression as a tool for DBS contact selection for akinetic-rigid symptoms in Parkinson's disease.

机构信息

University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne, Germany.

University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.

出版信息

Parkinsonism Relat Disord. 2023 Jul;112:105478. doi: 10.1016/j.parkreldis.2023.105478. Epub 2023 Jun 12.

Abstract

BACKGROUND

Suppression of pathologically altered activity in the beta-band has previously been suggested as a biomarker for feedback-based neurostimulation in subthalamic deep brain stimulation (STN-DBS) for Parkinson's Disease (PD).

OBJECTIVE

To assess the utility of beta-band suppression as a tool for contact selection in STN-DBS for PD.

METHODS

A sample of seven PD patients (13 hemispheres) with newly implanted directional DBS leads of the STN were recorded during a standardized monopolar contact review (MPR). Recordings were received from contact pairs adjacent to the stimulation contact. The degree of beta-band suppression for each investigated contact was then correlated to the respective clinical results. Additionally, we have implemented a cumulative ROC analysis, to test the predictive value of beta-band suppression on the clinical efficacy of the respective contacts.

RESULTS

Stimulation ramping led to frequency-specific changes in the beta-band, while lower frequencies remained unaffected. Most importantly, our results showed that the degree of low beta-band suppression from baseline activity (stimulation off) served as a predictor for clinical efficacy of the respective stimulation contact. In contrast suppression of high beta-band activity yielded no predictive power.

CONCLUSION

The degree of low beta-band suppression can serve as a time-saving, objective tool for contact selection in STN-DBS.

摘要

背景

先前有研究表明,在帕金森病(PD)的丘脑底核(STN)深部脑刺激(DBS)中,抑制病理性改变的β频带活动可以作为基于反馈的神经刺激的生物标志物。

目的

评估β频带抑制作为 PD 患者 STN-DBS 中接触选择工具的效用。

方法

对 7 名新植入 STN 定向 DBS 导联的 PD 患者(13 个半球)在标准化单极接触复查(MPR)期间进行记录。记录来自刺激接触点相邻的接触对。然后将每个研究接触点的β频带抑制程度与相应的临床结果相关联。此外,我们还实施了累积 ROC 分析,以测试β频带抑制对各自接触点临床疗效的预测价值。

结果

刺激升压导致β频带的频率特异性变化,而低频保持不受影响。最重要的是,我们的结果表明,从基线活动(刺激关闭)开始的低频β频带抑制程度可作为各自刺激接触点临床疗效的预测指标。相比之下,高频β频带活动的抑制没有预测能力。

结论

低频β频带抑制的程度可以作为 STN-DBS 中接触选择的一种省时、客观的工具。

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