Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Department of Neurology, University of Washington, Seattle, WA, USA.
Tremor Other Hyperkinet Mov (N Y). 2024 Sep 18;14:46. doi: 10.5334/tohm.916. eCollection 2024.
Deep brain stimulation for dystonia improves motor symptoms but variable and delayed responses challenge patient selection, targeting, and device programming.
Here we studied intracranial electrophysiology in a patient with primary dystonia and observed evoked resonant neural activity (ERNA) in the globus pallidus interna. These local stimulus-evoked potentials displayed refractory periods and paired-pulse facilitation at clinically relevant interstimulus intervals. Sensing from directional DBS contacts localized ERNA to an effective stimulation site in the ventral posterolateral portion of the pallidum.
To the best of our knowledge, this is the first observation of ERNA in the globus pallidus interna in a patient with primary dystonia. Stimulus-evoked activity could eventually guide both directional and adaptive stimulation for dystonia and other complex neuropsychiatric disorders.
深部脑刺激治疗肌张力障碍可改善运动症状，但可变且延迟的反应对患者选择、靶向和设备编程提出了挑战。
在这里，我们研究了一名原发性肌张力障碍患者的颅内电生理学，并观察到了苍白球内侧的诱发性共振神经活动（ERNA）。这些局部刺激诱发的电位在临床相关的刺激间隔下显示出不应期和成对脉冲易化。从定向 DBS 触点中感知到的 ERNA 定位于苍白球腹后外侧的有效刺激部位。
据我们所知，这是首次在原发性肌张力障碍患者的苍白球内侧观察到 ERNA。刺激诱发的活动最终可能指导肌张力障碍和其他复杂神经精神障碍的定向和自适应刺激。
