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小脑刺激对帕金森病患者的调节。

Modulation of Cerebellar Oscillations with Subthalamic Stimulation in Patients with Parkinson's Disease.

机构信息

Department of Psychology, University of South Dakota, Vermillion, SD, USA.

Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA.

出版信息

J Parkinsons Dis. 2024;14(7):1417-1426. doi: 10.3233/JPD-240065.


DOI:10.3233/JPD-240065
PMID:39331106
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11492035/
Abstract

BACKGROUND: Deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) has emerged as a potent treatment for alleviating motor symptoms in Parkinson's disease (PD). Despite its effectiveness, the impact of high frequency STN-DBS on cerebellar oscillations remains unclear, posing an intriguing challenge for neural modulation. Given the direct and indirect connections between the STN and cerebellum, we investigated whether STN-DBS affects cerebellar oscillations. OBJECTIVE: To observe the effects of STN-DBS on cerebellar oscillations in patients with PD. METHODS: We recruited 15 PD patients receiving STN-DBS. Electroencephalographic (EEG) signals were recorded from cerebellar regions during resting-state conditions in both the OFF-DBS and STN-DBS conditions. Our analyses centered on spectral features, particularly theta and beta oscillations, guided by prior research and correlation tests to investigate the relationship between oscillatory changes and motor symptom severity. RESULTS: In the mid-cerebellar (Cbz) region, we observed a significant increase in the relative power in all frequency bands, including theta and beta oscillations during STN-DBS, showing the global effect of DBS. Importantly, the correlation results indicated significant associations between mid-cerebellar (Cbz) beta power during the OFF condition and motor severity, which were not evident during STN-DBS. Interestingly, correlations between beta power and motor severity were not observed at the mid-occipital (Oz) and mid-frontal (Cz) regions. Notably, signal similarity analyses demonstrated no evidence of volume conduction effects between the mid-cerebellar (Cbz) and nearby mid-occipital (Oz) regions. CONCLUSIONS: While these findings provide valuable insights into the complex interplay between STN-DBS and neural oscillations, further research is essential to decipher their precise functional significance and clinical implications. Understanding these intricacies may contribute to the optimization of DBS therapies for PD.

摘要

背景:深部脑刺激(DBS)靶向丘脑底核(STN)已成为缓解帕金森病(PD)运动症状的有效治疗方法。尽管其效果显著,但高频 STN-DBS 对小脑振荡的影响仍不清楚,这对神经调节提出了一个有趣的挑战。鉴于 STN 与小脑之间的直接和间接联系,我们研究了 STN-DBS 是否会影响小脑振荡。

目的:观察 STN-DBS 对 PD 患者小脑振荡的影响。

方法:我们招募了 15 名接受 STN-DBS 的 PD 患者。在 OFF-DBS 和 STN-DBS 条件下,在静息状态下从小脑区域记录脑电图(EEG)信号。我们的分析集中在频谱特征上,特别是在先前研究和相关测试的指导下,研究了振荡变化与运动症状严重程度之间的关系。

结果:在中脑(Cbz)区域,我们观察到在 STN-DBS 期间所有频段(包括 theta 和 beta 振荡)的相对功率显著增加,显示出 DBS 的全局效应。重要的是,相关结果表明,在 OFF 条件下,中脑(Cbz)beta 功率与运动严重程度之间存在显著相关性,而在 STN-DBS 期间则不明显。有趣的是,在中枕部(Oz)和中额部(Cz)区域,beta 功率与运动严重程度之间没有相关性。值得注意的是,信号相似性分析表明,中脑(Cbz)和附近中枕部(Oz)区域之间没有证据表明体积传导效应。

结论:虽然这些发现为 STN-DBS 与神经振荡之间的复杂相互作用提供了有价值的见解,但需要进一步研究来破译其确切的功能意义和临床意义。了解这些复杂性可能有助于优化 PD 的 DBS 治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeca/11492035/34aa8010f03a/jpd-14-jpd240065-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeca/11492035/4e1f39bcc142/jpd-14-jpd240065-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeca/11492035/34aa8010f03a/jpd-14-jpd240065-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeca/11492035/4e1f39bcc142/jpd-14-jpd240065-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeca/11492035/34aa8010f03a/jpd-14-jpd240065-g002.jpg

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引用本文的文献

[1]
Cerebellar Oscillatory Patterns in Essential Tremor: Modulatory Effects of VIM-DBS.

Cerebellum. 2025-2-1

本文引用的文献

[1]
Effects of Very Low- and High-Frequency Subthalamic Stimulation on Motor Cortical Oscillations During Rhythmic Lower-Limb Movements in Parkinson's Disease Patients.

J Parkinsons Dis. 2023

[2]
Cerebellar oscillatory dysfunction during lower-limb movement in Parkinson's disease with freezing of gait.

Brain Res. 2023-6-1

[3]
Physiological Recordings of the Cerebellum in Movement Disorders.

Cerebellum. 2023-10

[4]
Subthalamic Nucleus Modulation of the Pontine Nuclei and Its Targeting of the Cerebellar Cortex.

J Neurosci. 2022-7-13

[5]
Cortical and Cerebellar Oscillatory Responses to Postural Instability in Parkinson's Disease.

Front Neurol. 2021-11-4

[6]
Resting-State Low-Frequency Cerebellar Oscillations Can Be Abnormal in Parkinson's Disease.

Cerebellum. 2022-12

[7]
Altered Cerebellar Oscillations in Parkinson's Disease Patients during Cognitive and Motor Tasks.

Neuroscience. 2021-11-1

[8]
Low-frequency STN-DBS provides acute gait improvements in Parkinson's disease: a double-blinded randomised cross-over feasibility trial.

J Neuroeng Rehabil. 2021-8-10

[9]
Can EEG and MEG detect signals from the human cerebellum?

Neuroimage. 2020-7-15

[10]
Frontal theta and beta oscillations during lower-limb movement in Parkinson's disease.

Clin Neurophysiol. 2020-1-13

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