Discipline of Psychology, College of Science, Health, Engineering and Education, Western Australia, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Western Australia, Australia.
Hollywood Private Hospital, Western Australia, Australia.
Neurobiol Dis. 2024 Jun 15;196:106518. doi: 10.1016/j.nbd.2024.106518. Epub 2024 Apr 26.
Resting tremor is the most common presenting motor symptom in Parkinson's disease (PD). The supplementary motor area (SMA) is a main target of the basal-ganglia-thalamo-cortical circuit and has direct, facilitatory connections with the primary motor cortex (M1), which is important for the execution of voluntary movement. Dopamine potentially modulates SMA and M1 activity, and both regions have been implicated in resting tremor. This study investigated SMA-M1 connectivity in individuals with PD ON and OFF dopamine medication, and whether SMA-M1 connectivity is implicated in resting tremor. Dual-site transcranial magnetic stimulation was used to measure SMA-M1 connectivity in PD participants ON and OFF levodopa. Resting tremor was measured using electromyography and accelerometry. Stimulating SMA inhibited M1 excitability OFF levodopa, and facilitated M1 excitability ON levodopa. ON medication, SMA-M1 facilitation was significantly associated with smaller tremor than SMA-M1 inhibition. The current findings contribute to our understanding of the neural networks involved in PD which are altered by levodopa medication and provide a neurophysiological basis for the development of interventions to treat resting tremor.
静止性震颤是帕金森病(PD)最常见的运动症状。辅助运动区(SMA)是基底节-丘脑-皮质回路的主要靶点,与初级运动皮层(M1)有直接的促进连接,这对执行随意运动很重要。多巴胺可能调节 SMA 和 M1 的活动,这两个区域都与静止性震颤有关。本研究在 PD 患者服用和不服用多巴胺药物时,研究了 SMA-M1 的连接,以及 SMA-M1 的连接是否与静止性震颤有关。双部位经颅磁刺激用于测量 PD 参与者在服用和不服用左旋多巴时的 SMA-M1 连接。使用肌电图和加速度计测量静止性震颤。刺激 SMA 在不服用左旋多巴时抑制 M1 兴奋性,在服用左旋多巴时促进 M1 兴奋性。在服用药物时,SMA-M1 促进与较小的震颤显著相关,而不是 SMA-M1 抑制。目前的研究结果有助于我们了解受左旋多巴药物改变的 PD 相关神经网络,并为治疗静止性震颤的干预措施的发展提供神经生理学基础。