Zifman Noa, Levy-Lamdan Ofri, Hiller Tal, Thaler Avner, Dolev Iftach, Mirelman Anat, Fogel Hilla, Hallett Mark, Maidan Inbal
QuantalX Neuroscience Ltd., Kfar Saba, Israel.
Laboratory of Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
NPJ Parkinsons Dis. 2024 Sep 30;10(1):182. doi: 10.1038/s41531-024-00793-0.
Distinguishing Parkinson's disease (PD) subgroups may be achieved by observing network responses to external stimuli. We compared TMS-evoked potential (TEP) measures from stimulation of bilateral motor cortex (M1), dorsolateral prefrontal cortex (DLPFC), and visual cortex (V1) between 62 PD patients (age: 69.9 ± 7.5) and 76 healthy controls (age: 69.2 ± 4.3) using a TMS-EEG protocol. TEP measures were analyzed using two-way ANCOVA adjusted for MOCA. PD patients were divided into tremor dominant (TD), non-tremor dominant (NTD) and rapid disease progression (RDP) subgroups. PD patients showed lower wide-waveform adherence (wWFA) (p = 0.025) and interhemispheric connectivity (IHC) (p < 0.001) compared to healthy controls. Lower occipital IHC correlated with advanced disease stage (r = -0.37, p = 0.0039). The RDP and NTD groups showed lower wWFA in response to occipital stimulation than the TD group (p = 0.005). Occipital TEP measures identified RDP patients with 85% accuracy. These findings demonstrate occipital network involvement in early PD stages, suggesting that TEP measures offer insights into altered networks in PD subgroups.
通过观察网络对外界刺激的反应，可能实现帕金森病（PD）亚组的区分。我们使用经颅磁刺激-脑电图（TMS-EEG）方案，比较了62例PD患者（年龄：69.9±7.5）和76例健康对照者（年龄：69.2±4.3）双侧运动皮层（M1）、背外侧前额叶皮层（DLPFC）和视觉皮层（V1）受刺激后的经颅磁刺激诱发电位（TEP）测量值。使用经蒙特利尔认知评估量表（MOCA）校正的双向协方差分析对TEP测量值进行分析。PD患者被分为震颤为主型（TD）、非震颤为主型（NTD）和疾病快速进展型（RDP）亚组。与健康对照者相比，PD患者表现出更低的宽波形依从性（wWFA）（p = 0.025）和半球间连接性（IHC）（p < 0.001）。枕叶IHC降低与疾病晚期相关（r = -0.37，p = 0.0039）。RDP组和NTD组对枕叶刺激的反应中wWFA低于TD组（p = 0.005）。枕叶TEP测量能够以85%的准确率识别RDP患者。这些发现表明枕叶网络在PD早期阶段就受累，提示TEP测量可为深入了解PD亚组中改变的网络提供线索。
