丘脑底核的低频/高频刺激改善帕金森病患者的言语流畅性并维持运动控制

Low/High Multi-Frequency Stimulation of the Subthalamic Nucleus Improves Verbal Fluency Maintaining Motor Control in Parkinson's Disease.

作者信息

Ricciardi Lucia, Cucinotta Francescopaolo, Pegolo Elena, Abundes-Corona Arturo, Ishihara Bryony, Hossain Israt, Sawacha Zimi, Hart Michael, Pereira Erlick, Morgante Francesca, Fasano Alfonso

机构信息

Neurosciences and Cell Biology Institute, Neuromodulation and Motor Control Section, City St George's University of London, London, United Kingdom.

Department of Neurology, University of California San Francisco, San Francisco, California, USA.

出版信息

Mov Disord. 2025 Sep;40(9):1892-1900. doi: 10.1002/mds.30254. Epub 2025 Jun 11.

DOI:10.1002/mds.30254

PMID:40501019

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12485583/

Abstract

BACKGROUND

High frequency deep brain stimulation of the subthalamic nucleus (STN-DBS) is a well-established therapy for Parkinson's disease (PD) motor symptoms, however, its effect on non-motor symptoms is controversial. Low frequency DBS can improve cognition, but its effects on motor functions are detrimental.

OBJECTIVE

Our goal was to evaluate the effect on verbal fluency (VF) of dual frequency STN-DBS combining high and low frequency (130 + 10 Hz) as compared to 130 Hz or 10 Hz alone and to OFF stimulation. The effect on motor symptoms, working memory, and subjective feelings was also assessed.

METHODS

We used a randomized order of experimental conditions with a double-blind design to assess the effects of 130 Hz, 10 Hz, and 130 + 10 Hz stimulation as compared to OFF stimulation in 18 PD patients with STN-DBS. In each condition, participants completed: phonemic and action VF, N-back task, and visual analogue scales for fatigue and stress level. Motor functions and gait velocity were also assessed. Friedman analysis of variance were conducted to determine whether change scores from baseline OFF stimulation, in our primary (VF) and secondary outcomes measures (motor functions, N-back task, subjective feelings) were different in the three stimulation conditions.

RESULTS

VF improved more in the 130 + 10 Hz condition than 130 Hz condition (P = 0.006); there was no difference between 130 + 10 Hz and 10 Hz (P = 0.2) and between 130HZ and 10 Hz (P = 0.6). There was a significant difference among the stimulation conditions for the motor score (χ(2) = 11.1, P = 0.004), it being worse at 10 Hz than 130 Hz (P = 0.002) and 130 + 10 Hz (P = 0.01).

CONCLUSIONS

Dual frequency STN-DBS improves phonemic VF while maintaining a beneficial effect on motor signs of PD. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

摘要

背景

丘脑底核高频深部脑刺激（STN-DBS）是治疗帕金森病（PD）运动症状的一种成熟疗法，然而，其对非运动症状的影响存在争议。低频DBS可改善认知，但对运动功能有不利影响。

目的

我们的目标是评估与单独的130Hz或10Hz以及关闭刺激相比，高频和低频（130 + 10Hz）联合的双频STN-DBS对言语流畅性（VF）的影响。还评估了对运动症状、工作记忆和主观感受的影响。

方法

我们采用随机顺序的实验条件和双盲设计，评估18例接受STN-DBS的PD患者中130Hz、10Hz和130 + 10Hz刺激与关闭刺激相比的效果。在每种条件下，参与者完成：音素和动作VF、N-back任务以及疲劳和压力水平的视觉模拟量表。还评估了运动功能和步态速度。进行Friedman方差分析以确定在三种刺激条件下，我们的主要（VF）和次要结局指标（运动功能、N-back任务、主观感受）与关闭刺激基线相比的变化分数是否不同。

结果

130 + 10Hz条件下的VF改善比130Hz条件下更多（P = 0.006）；130 + 10Hz与10Hz之间无差异（P = 0.2），130Hz与10Hz之间也无差异（P = 0.6）。运动评分在刺激条件之间存在显著差异（χ(2)=11.1，P = 0.004），10Hz时比130Hz（P = 0.002）和130 + 10Hz（P = 0.01）时更差。