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Subthalamic stimulation impairs stopping of ongoing movements.

丘脑底刺激损害持续运动的停止。

  • 影响因子:7.52
  • DOI:10.1093/brain/awaa341
  • 作者列表:"Lofredi R","Auernig GC","Irmen F","Nieweler J","Neumann WJ","Horn A","Schneider GH","Kühn AA
  • 发表时间:2021-02-12
Abstract

:The subthalamic nucleus is part of a global stopping network that also includes the presupplementary motor area and inferior frontal gyrus of the right hemisphere. In Parkinson's disease, subthalamic deep brain stimulation improves movement initiation and velocity, but its effect on stopping of ongoing movement is unknown. Here, we examine the relation between movement stopping and connectivity of stimulation volumes to the stopping network. Stop and go times were collected in 17 patients with Parkinson's disease on and off subthalamic stimulation during visually cued initiation and termination of continuous, rotational movements. Deep brain stimulation contacts were localized; the stimulation volume computed and connectivity profiles estimated using an openly available, normative structural connectome. Subthalamic stimulation significantly increased stop times, which correlated with the connectivity of the stimulation volume to presupplementary motor area and inferior frontal gyrus of the right hemisphere. The robustness of this finding was validated using three separate analysis streams: voxel-wise whole-brain connectivity, region of interest connectivity and a tract-centred method. Our study sheds light on the role of the fronto-subthalamic inhibitory triangle in stopping of ongoing movements and may inspire circuit based adaptive stimulation strategies for control of stopping impairment, possibly reflected in stimulation-induced dyskinesia.

摘要

: 丘脑底核是全球停止网络的一部分,该网络还包括预设的辅助运动区和右半球的额下回。在帕金森氏病中,丘脑下深部脑刺激改善运动启动和速度,但其对停止正在进行的运动的影响是未知的。在这里,我们检查了运动停止和刺激体积与停止网络的连通性之间的关系。在视觉提示的连续旋转运动的启动和终止期间,收集17名帕金森病患者的停止和停止丘脑下刺激时间。定位深部脑刺激接触; 使用公开可用的规范结构连接组计算刺激体积并估计连接概况。丘脑底刺激显著增加停止时间,这与刺激体积与预设辅助运动区和右半球额下回的连通性相关。使用三个独立的分析流验证了这一发现的稳健性: 体素全脑连接性、感兴趣区域连接性和以束为中心的方法。我们的研究揭示了额丘脑-底丘脑抑制三角在停止正在进行的运动中的作用,并可能激发基于回路的适应性刺激策略来控制停止损伤,这可能反映在刺激诱导的运动障碍中。

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