A comprehensive investigation into the mechanisms of action of deep brain stimulation in Parkinson's disease and its significance in determining the target of stimulation

全面探讨脑深部电刺激治疗帕金森病的作用机制及其对确定刺激靶点的意义

基本信息

批准号：
22590954
负责人：
TERAO Yasuo
金额：
$ 2.83万
依托单位：
The University of Tokyo
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2010
资助国家：
日本
起止时间：
2010 至 2012
项目状态：
已结题

项目摘要

Deep brain stimulation (DBS) of the basal ganglia has come to be widely used for the treatment of Parkinson’s disease (PD). However, the exact mechanism of action at the systems level as well as its effect on cognition is largely unknown. The goal of the present study was to elucidate the mechanism of DBS of STN and other targets on cognitive function. In the first part of experiments, we devised cognitive tasks including temporal processing and visual search tasks to study the cognitive efficiency of PD patients With the STN DBS switched on and off, PD patients also performed a visual search task in which subjects had to find a target from among an array of distractors. DBS not only improved the efficiency of visual search but also the saccade amplitudes during the task. The cognitive tasks used proved useful for evaluating the cognitive functions in PD patients undergoing pre-surgical assessment. The effect of GPi DBS on saccade parameters was relatively small, although it had a significant effect on motor symptoms of PD, in contrast to subthalamic DBS improving the amplitudes of saccades in all tasks studied, suggesting that the mechanisms of actions of STN DBS and GPi DBS were different. Using the cognitive tasks in combination with the clinical assessment of the effect of DBS would not only provide insights into the mechanism of cognitive impairment induced by DBS but also be helpful for selecting targets for DBS.

巴萨神经节的深脑刺激（DB）已被广泛用于治疗帕金森氏病（PD）。但是，在系统层面上的确切作用机理及其对认知的影响在很大程度上尚不清楚。本研究的目的是阐明STN的DBS机制以及其他靶标在认知功能上。在实验的第一部分中，我们设计了认知任务，包括临时处理和视觉搜索任务，以研究开关和关闭STN DBS的PD患者的认知效率，PD患者还执行了视觉搜索任务，其中受试者必须从一系列干扰器中找到目标。 DB不仅提高了视觉搜索的效率，还提高了任务过程中的扫视放大器。事实证明，使用的认知任务可用于评估接受术前评估的PD患者的认知功能。 GPI DBS对扫视参数的影响相对较小，尽管它对PD的运动症状具有显着影响，而与丘脑下DBS相比，在所有任务中都改善了扫视的放大器，这表明STN DBS和GPI DBS的作用机制不同。将认知任务与DBS效应的临床评估结合使用，不仅可以提供有关DBS引起的认知障碍机制的见解，而且还有助于选择DBS的靶标。