Thein Julia, Linnhoff Stefanie, Voges Jürgen, Galazky Imke, Zaehle Tino
Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany.
Stereotactic Neurosurgery, Otto-von-Guericke University, Magdeburg, Germany.
Am J Med. 2024 Jul;137(7):673-676. doi: 10.1016/j.amjmed.2024.03.019. Epub 2024 Mar 16.
The concomitant stimulation of the subthalamic nucleus and the substantia nigra pars reticulata is a promising approach to improve treatment of refractory axial symptoms in Parkinson's disease. While dual stimulation of the subthalamic nucleus and the substantia nigra pars reticulata has previously shown beneficial effects on gait, the role of the substantia nigra, a crucial component of the basal ganglia circuitry, in cognitive functions such as attention and executive control remains underexplored. This study aimed to investigate the impact of selective substantia nigra pars reticulata stimulation on attentional performance in patients receiving standard deep brain stimulation of the subthalamic nucleus.
Twelve patients with bilateral subthalamic nucleus stimulation underwent computerized assessment of attention using a simple reaction time task. Reaction times were assessed under standard stimulation of the subthalamic nucleus versus simultaneous stimulation of the subthalamic nucleus and the substantia nigra pars reticulata.
The results revealed a significant improvement in reaction times during the simple reaction time task when patients received dual stimulation compared to standard stimulation.
Our findings provide further evidence for the pivotal role of the substantia nigra pars reticulata in cognitive functions such as attention. Despite the limitations of the study, including a small sample size, our results suggest potential benefits of simultaneous deep brain stimulation of the subthalamic nucleus and the substantia nigra pars reticulata on attentional performance in patients with Parkinson's disease. Further research with larger cohorts is warranted to confirm these findings and better understand the underlying mechanisms.
同时刺激丘脑底核和黑质网状部是改善帕金森病难治性轴性症状治疗的一种有前景的方法。虽然先前丘脑底核和黑质网状部的双重刺激已显示对步态有有益影响，但黑质作为基底神经节回路的关键组成部分，在注意力和执行控制等认知功能中的作用仍未得到充分探索。本研究旨在调查选择性刺激黑质网状部对接受丘脑底核标准深部脑刺激的患者注意力表现的影响。
12名接受双侧丘脑底核刺激的患者使用简单反应时间任务进行了注意力的计算机评估。在丘脑底核的标准刺激与丘脑底核和黑质网状部的同时刺激下评估反应时间。
结果显示，与标准刺激相比，患者接受双重刺激时，简单反应时间任务中的反应时间有显著改善。
我们的研究结果为黑质网状部在注意力等认知功能中的关键作用提供了进一步证据。尽管本研究存在局限性，包括样本量小，但我们的结果表明，同时对丘脑底核和黑质网状部进行深部脑刺激对帕金森病患者的注意力表现可能有益。有必要进行更大样本量的进一步研究以证实这些发现并更好地理解潜在机制。
