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PD

神经

关键词神经 疾病 临床疾病

词汇介绍

拓展阅读

解析

Parkinson's disease  英 ['pa:kinsnz dizi:z]

          [内科]帕金森氏病;震颤性麻痹

        Scientists have shown that the first gene-based therapy developed for Parkinson's disease substantially alleviates the symptoms of the condition without the need to leave any devices in the body. 科学家首次展示了一种针对帕金森氏病的基因疗法,这种疗法可以实质性地缓解这种病患的症状而无需在患者体内植入任何器件。

概述

帕金森症是指各种原因(脑血管病、脑动脉硬化、感染、中毒、外伤、药物以及遗传变性等)造成的以运动迟缓为主的一组临床综合征,主要表现为震颤、肌僵直、运动迟缓和姿势不稳等。包括原发性帕金森病、帕金森叠加综合征、继发性帕金森综合征和遗传变性性帕金森综合征。典型症状运动障碍、震颤、强直、姿势与步态异常及面容呆板。易激动,偶有阵发性冲动行为。随着病情的发展,穿衣、洗脸、刷牙等日常生活都出现困难。另外,有的患者还可出现植物神经功能紊乱,如油脂脸、多汗、垂涎、大小便困难和直立性低血压,也可出现忧郁和痴呆的症

Deep brain stimulation for Parkinson's disease modulates highfrequency evoked and spontaneous neural activity复制标题

帕金森病的深部脑刺激调节高频诱发和自发神经活动

发表时间:2019-07-01

影响因子:5.2

作者: Nicholas C

期刊:NEUROBIOL DIS

Deep brain stimulation is an established therapy for Parkinson's disease; however, its effectiveness is hindered by limited understanding of therapeutic mechanisms and the lack of a robust feedback signal for tailoring stimulation. We recently reported that subthalamic nucleus deep brain stimulation evokes a neural response resembling a decaying high-frequency (200-500 Hz) oscillation that typically has a duration of at least 10 ms and is localizable to the dorsal sub-region. As the morphology of this response suggests a propensity for the underlying neural circuitry to oscillate at a particular frequency, we have named it evoked resonant neural activity. Here, we determine whether this evoked activity is modulated by therapeutic stimulation - a critical attribute of a feedback signal. Furthermore, we investigated whether any related changes occurred in spontaneous local field potentials. Evoked and spontaneous neural activity was intraoperatively recorded from 19 subthalamic nuclei in patients with Parkinson's disease. Recordings were obtained before therapeutic stimulation and during 130 Hz stimulation at increasing amplitudes (0.67-3.38 mA), 'washout' of therapeutic effects, and non-therapeutic 20 Hz stimulation. Therapeutic efficacy was assessed using clinical bradykinesia and rigidity scores. The frequency and amplitude of evoked resonant neural activity varied with the level of 130 Hz stimulation (p < .001). This modulation coincided with improvement in bradykinesia and rigidity (p < .001), and correlated with spontaneous beta band suppression (p < .001). Evoked neural activity occupied a similar frequency band to spontaneous high-frequency oscillations (200-400 Hz), both of which decreased to around twice the 130 Hz stimulation rate. Non-therapeutic stimulation at 20 Hz evoked, but did not modulate, resonant activity.

译文

深部脑刺激是帕金森病的既定疗法;然而,其有效性受到对治疗机制的有限理解和缺乏用于定制刺激的强大反馈信号的阻碍。我们最近报道,丘脑底核深部脑刺激引起类似于衰减的高频(200-500Hz)振荡的神经反应,其通常具有至少10ms的持续时间并且可定位于背侧亚区域。由于这种反应的形态表明潜在的神经回路倾向于以特定频率振荡,我们将其命名为诱发共振神经活动。在这里,我们确定这种诱发活动是否受到治疗刺激的调节 - 这是反馈信号的关键属性。此外,我们调查了自发局部场电位是否发生任何相关变化。在帕金森病患者的19个丘脑底核中术中记录了诱发和自发的神经活动。在治疗性刺激之前和130Hz刺激期间以增加的振幅(0.67-3.38mA),治疗效果的“清除”和非治疗性20Hz刺激获得记录。使用临床运动迟缓和刚性评分评估治疗功效。诱发共振神经活动的频率和幅度随130Hz刺激水平而变化(p <.001)。这种调节与运动迟缓和刚性的改善相一致(p <.001),并且与自发β带抑制相关(p <.001)。诱发的神经活动占据了与自发高频振荡(200-400Hz)相似的频带,两者都降低到130Hz刺激率的两倍左右。诱发20Hz的非治疗性刺激,但没有调节,共振活动。