Cortical Network Modulation by Subthalamic Nucleus Deep Brain Stimulation

丘脑底核深部脑刺激的皮质网络调节

• 批准号: 9817262
• 负责人: JOSEPH P CULVER
• 金额: $ 58.54万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-06 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9817262
• 关键词: 3-Dimensional; Affect; Anatomy; Area; Auditory; Behavior; Behavioral; Brain; Characteristics; Clinical; Clinical Treatment; Cognition; Cognitive; Collection; Complex; Corpus striatum structure; Data; Deep Brain Stimulation; Dorsal; Double-Blind Method; Enrollment; Evaluation; Experimental Designs; Functional Magnetic Resonance Imaging; Future; Head; Human; Image; Impaired cognition; Implant; Individual; Lead; Literature; Location; Magnetic Resonance Imaging; Maps; Measurable; Measurement; Measures; Mediating; Metals; Methods; Moods; Morphologic artifacts; Motor; Movement; Nature; Near-Infrared Spectroscopy; Operative Surgical Procedures; Parkinson Disease; Patients; Physiology; Play; Positron-Emission Tomography; Problem Solving; Property; Radiation exposure; Resolution; Rest; Role; STN stimulation; Safety; Scalp structure; Scanning; Sensory; Side; Signal Transduction; Source; Specificity; Stream; Structure; Structure of subthalamic nucleus; System; Testing; Thalamic structure; Time; Validation; Visual; Work; cognitive change; density; diffuse optical tomography; hemodynamics; imaging detector; imaging modality; implantation; improved; motor disorder; neuromechanism; neuroregulation; novel; response; safe patient; side effect; support network; temporal measurement; tool

Deep brain stimulation of the subthalamic nucleus (STN DBS) can provide substantial motor benefit yet occasional mood and cognitive side effects in Parkinson disease (PD). Current literature hypothesizes that downstream network level effects are a critical mechanism of STN DBS’s influence on motor and non-motor behavior, however our ability to test this hypothesis has been limited. Common imaging modalities either do not have the temporal resolution necessary to discern resting state functional connectivity of cortical networks or are not suitable or safe for patients with implanted DBS. We have developed a novel high-density diffuse optical tomography (HD-DOT) system for measuring brain hemodynamics which can accurately map the functional connectivity of cortical resting state networks (RSN) or task-evoked responses within the first ~1cm of cortex. HD-DOT has comparable temporal and spatial resolution to fMRI, greater comfort than MRI or PET, no radiation exposure, no electrical artifacts, no metal artifacts and no contraindications or safety concerns for DBS patients. We have strong preliminary data showing the validity and feasibility of assessing cortical RSNs and task-induced responses in STN DBS patients. With our novel HD-DOT system, careful experimental design and rigorous analyses, this study will determine the nature of cortical RSN-level modulation induced by STN DBS and its relationship to DBS-induced motor and cognitive change. Controls and individuals with PD will be enrolled pre-surgically and scanned with HD-DOT and MRI (resting state BOLD, structural]). After implantation and optimization of DBS, PD individuals will be scanned with HD-DOT in several conditions. With these data, we will test hypotheses about networks that are responsive to important characteristics of STN DBS (e.g.location) and their relationship to motor and non-motor function. This information ultimately could provide methods for faster optimization of DBS parameters and help identify cortical nodes or networks involved in STN DBS-induced benefits or side effects that would provide future targets for less invasive neuromodulation. Finally, this work could reveal fundamental properties of cortical network physiology such as the capacity for plasticity in response to up-stream perturbations.

丘脑底核的深部脑刺激（STN DBS）可以提供显着的运动益处 帕金森病 (PD) 中偶尔出现的情绪和认知副作用。 下游网络水平效应是 STN DBS 对运动和非运动影响的关键机制 行为，但是我们检验这一假设的能力也受到限制。 不具备辨别皮质网络静息状态功能连接所需的时间分辨率 或对于植入 DBS 的患者不适合或不安全。我们开发了一种新型高密度弥散型。 用于测量脑部血流动力学的光学断层扫描 (HD-DOT) 系统，可准确绘制脑血流动力学图 皮质静息状态网络 (RSN) 的功能连接或前约 1 厘米内的任务诱发反应 HD-DOT 具有与 fMRI 相当的时间和空间分辨率，比 MRI 或 PET 更舒适， 无辐射暴露，无电气伪影，无金属伪影，无禁忌症或安全问题 DBS 患者有强有力的初步数据显示评估皮质 RSN 的有效性和可行性。 以及 STN DBS 患者的任务诱导反应 通过我们新颖的 HD-DOT 系统，进行了仔细的实验​​。 通过设计和严格的分析，本研究将确定皮质 RSN 水平调制的性质 STN DBS 及其与 DBS 引起的运动和认知变化的关系 对照组和 PD 患者。 将在手术前进行登记并进行 HD-DOT 和 MRI 扫描（静息状态粗体，结构]）。 DBS 的植入和优化，PD 个体将在多种情况下使用 HD-DOT 进行扫描。 这些数据，我们将测试有关响应 STN 重要特征的网络的假设 DBS（例如位置）及其与运动和非运动功能的关系最终可以。 提供更快优化 DBS 参数的方法，并帮助识别皮质节点或网络 涉及 STN DBS 引起的益处或副作用，这将为微创治疗提供未来目标 最后，这项工作可以揭示皮质网络生理学的基本特性，例如 响应上游扰动的可塑性能力。