Movement Disorders and Neuromodulation Centre, University California San Francisco, San Francisco, CA, USA.
Parkinson's Disease Research Education and Clinical Center, San Francisco Veteran's Affairs Medical Center, San Francisco, CA, USA.
Nat Commun. 2024 Feb 27;15(1):1793. doi: 10.1038/s41467-024-46002-7.
Sleep disturbance is a prevalent and disabling comorbidity in Parkinson's disease (PD). We performed multi-night (n = 57) at-home intracranial recordings from electrocorticography and subcortical electrodes using sensing-enabled Deep Brain Stimulation (DBS), paired with portable polysomnography in four PD participants and one with cervical dystonia (clinical trial: NCT03582891). Cortico-basal activity in delta increased and in beta decreased during NREM (N2 + N3) versus wakefulness in PD. DBS caused further elevation in cortical delta and decrease in alpha and low-beta compared to DBS OFF state. Our primary outcome demonstrated an inverse interaction between subcortical beta and cortical slow-wave during NREM. Our secondary outcome revealed subcortical beta increases prior to spontaneous awakenings in PD. We classified NREM vs. wakefulness with high accuracy in both traditional (30 s: 92.6 ± 1.7%) and rapid (5 s: 88.3 ± 2.1%) data epochs of intracranial signals. Our findings elucidate sleep neurophysiology and impacts of DBS on sleep in PD informing adaptive DBS for sleep dysfunction.
睡眠障碍是帕金森病（PD）中普遍存在且使人丧失能力的共病。我们对 4 名 PD 患者和 1 名颈肌张力障碍患者进行了多晚（n=57）的颅内记录，使用感应式深部脑刺激（DBS）进行了经颅电和皮质下电极的家庭内记录，并与便携式多导睡眠图进行了配对（临床试验：NCT03582891）。与清醒相比，PD 患者的非快速眼动（N2+N3）期间 delta 皮质下基底活动增加，beta 活动减少。与 DBS 关闭状态相比，DBS 导致皮质 delta 进一步升高，alpha 和低 beta 减少。我们的主要结果表明，在 NREM 期间，皮质下 beta 和皮质慢波之间存在反向相互作用。我们的次要结果表明，PD 患者在自发性觉醒前皮质下 beta 增加。我们使用颅内信号的传统（30 秒：92.6±1.7%）和快速（5 秒：88.3±2.1%）数据段，以高准确度对 NREM 与清醒进行了分类。我们的研究结果阐明了 PD 中的睡眠神经生理学以及 DBS 对睡眠的影响，为睡眠功能障碍的适应性 DBS 提供了信息。
