神经
词汇介绍
拓展阅读
解析
Parkinson's disease 英 ['pa:kinsnz dizi:z]
释 义 [内科]帕金森氏病；震颤性麻痹
例 句 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
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状。
运动障碍的特点
（1）运动不能。进行随意运动启动困难。（2）运动减少。自发、自动运动减少，运动幅度减少。（3）运动徐缓。随意运动执行缓慢。患者运动迟缓，随意动作减少，尤其是开始活动时表现动作困难吃力、缓慢。做重复动作时，幅度和速度均逐渐减弱。有的患者会出现语言困难，声音变小，音域变窄。吞咽困难，进食饮水时可出现呛咳。有的患者起身时全身不动，维持数秒至数十分钟，叫做“冻结发作”。
注意
帕金森症早期常常让家属不在意，最初的表现看上去都不怎么是病态，所以很容易被忽视。最易忽视的就是面部表情呆板。面部无表情让人误认为不高兴，所以最容易被忽视。其次就是手抖，这种症状会让家人认为是刚搬过重的物品所以才会这样，常常没有当作一回事。还有一个身体僵直的症状，在别人看来，患者的身体会有走路向前冲的感觉，会被别人认为要摔倒，还会出现小碎步，家人多认为老年人都是这个样子，没有及时就医。抑郁症也是作为帕金森症的症状出现的，也是帕金森病的一个信号，抑郁甚至比颤抖等运动信号来得更早。
治疗
目前治疗帕金森症的方法一是药物治疗，二是手术治疗。多巴胺替代药物：美多巴，息宁控释片。多巴胺受体激动剂：泰舒达，森福罗。单胺氧化酶-B抑制剂：咪多吡（司来吉兰）、思吉宁。还有金刚烷胺、安坦等。帕金森症早期首选药物治疗，但有些患者长期服药后效果会明显减退，同时出现严重的副作用，这时可以考虑手术疗法。但手术只是缓解症状，不能根治疾病，术后仍需要药物治疗，只是可以减少剂量。目前常用的是深部脑刺激术（DBS），又称为脑起搏器，DBS手术是现在国际上流行的治疗帕金森病的方法，此手术的特点是：价格昂贵，但疗效长。
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
影响指数：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.
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