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底丘脑核深部脑刺激和延迟保留对帕金森病患者记忆引导伸手表现的影响。

The Effects of Subthalamic Nucleus Deep Brain Stimulation and Retention Delay on Memory-Guided Reaching Performance in People with Parkinson's Disease.

机构信息

Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.

Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

出版信息

J Parkinsons Dis. 2023;13(6):917-935. doi: 10.3233/JPD-225041.

Abstract

BACKGROUND

Subthalamic nucleus deep brain stimulation (STN-DBS) improves intensive aspects of movement (velocity) in people with Parkinson's disease (PD) but impairs the more cognitively demanding coordinative aspects of movement (error). We extended these findings by evaluating STN-DBS induced changes in intensive and coordinative aspects of movement during a memory-guided reaching task with varying retention delays.

OBJECTIVE

We evaluated the effect of STN-DBS on motor control during a memory-guided reaching task with short and long retention delays in participants with PD and compared performance to healthy controls (HC).

METHODS

Eleven participants with PD completed the motor section of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS III) and performed a memory-guided reaching task under four different STN-DBS conditions (DBS-OFF, DBS-RIGHT, DBS-LEFT, and DBS-BOTH) and two retention delays (0.5 s and 5 s). An additional 13 HC completed the memory-guided reaching task.

RESULTS

Unilateral and bilateral STN-DBS improved the MDS-UPDRS III scores. In the memory-guided reaching task, both unilateral and bilateral STN-DBS increased the intensive aspects of movement (amplitude and velocity) in the direction toward HC but impaired coordinative aspects of movement (error) away from the HC. Furthermore, movement time was decreased but reaction time was unaffected by STN-DBS. Shorter retention delays increased amplitude and velocity, decreased movement times, and decreased error, but increased reaction times in the participants with PD. There were no interactions between STN-DBS condition and retention delay.

CONCLUSION

STN-DBS may affect cognitive-motor functioning by altering activity throughout cortico-basal ganglia networks and the oscillatory activity subserving them.

摘要

背景

丘脑底核深部脑刺激(STN-DBS)改善了帕金森病(PD)患者运动的密集方面(速度),但损害了运动更具认知挑战性的协调方面(误差)。我们通过评估 STN-DBS 在具有不同保留延迟的记忆引导伸手任务中对密集和协调运动方面的诱导变化,扩展了这些发现。

目的

我们评估了 STN-DBS 对 PD 患者在具有短和长保留延迟的记忆引导伸手任务中的运动控制的影响,并将表现与健康对照(HC)进行了比较。

方法

11 名 PD 参与者完成了运动障碍协会统一帕金森病评定量表(MDS-UPDRS III)的运动部分,并在 4 种不同的 STN-DBS 条件(DBS-OFF、DBS-RIGHT、DBS-LEFT 和 DBS-BOTH)和 2 种保留延迟(0.5s 和 5s)下进行了记忆引导伸手任务。另外 13 名 HC 完成了记忆引导伸手任务。

结果

单侧和双侧 STN-DBS 改善了 MDS-UPDRS III 评分。在记忆引导伸手任务中,单侧和双侧 STN-DBS 均增加了参与者向 HC 方向的运动密集度(幅度和速度),但损害了远离 HC 的运动协调性(误差)。此外,STN-DBS 降低了运动时间,但不影响反应时间。较短的保留延迟增加了幅度和速度,减少了运动时间,并减少了参与者的误差,但增加了反应时间。STN-DBS 条件和保留延迟之间没有相互作用。

结论

STN-DBS 可能通过改变皮质基底节网络及其支持的振荡活动来影响认知运动功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/621c/10578280/f9b4d2b58fe3/jpd-13-jpd225041-g001.jpg

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