在基本震中评估DBS ON/OFF状态之间的功能连接差异
Albert J Fenoy1, Zili D Chu2, Robert J Ritter3
1Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA; Departments of Neurosurgery and Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
概括
牙 - 脊髓 - 丘脑管 (DRTt) 的深度大脑刺激 (DBS) 有效地治疗基本震 (ET). 功能性MRI揭示了运动区域的显著连接性变化,与震的改善相关,并影响了步行性.
科学领域:
- 神经科学是一个神经科学.
- 神经外科 神经外科
- 医疗成像医学成像
背景情况:
- 针对腹中介 (Vim) 核的深度大脑刺激 (DBS) 是基本震 (ET) 的首要治疗方法.
- 牙 - 脊髓 - thalamic通道 (DRTt),一个关键的输入/输出通道的Vim,是一个关键的目标在ET的DBS.
- 了解DRTT DBS在网络层面的影响对于优化震控制和管理步行性症至关重要.
研究的目的:
- 为了研究在DBS ON状态下与DBS OFF状态下基本震患者的功能连接性差异.
- 为了确定大脑区域,其连接性变化与震改善和/或步行性症严重程度相关.
- 探索连接模式作为预测DBS结果的生物标志物的潜力.
主要方法:
- 休息状态功能性MRI (rsfMRI) 用于评估15名ET患者的全脑和感兴趣区域 (ROI) 功能连接.
- 用DBS ON (最佳参数) 获取数据,并在DBS OFF之后立即获取数据.
- 双回归分析和随机排列测试用于统计分析,记录了震和动脉的严重程度得分.
主要成果:
- 所有患者都在DBS ON (p < 0.001) 治疗后显著改善了震.
- 全脑分析发现,在DBS状态之间,左前中心和左补充运动区域的连接性发生了显著的变化.
- 多个ROI的连接性变化,包括皮质和小脑区域,与震改善和持续时间有显著的相关性. 患有较大的动力衰竭的患者在DBS启动时表现出功能连接性下降.
结论:
- DRTt的DBS诱导了主要电机网络之外的广泛的功能连接变化,与震控制相关.
- 在特定的皮质和小脑区域的连接性改变可以作为生物标志物来预测DBS在基本震中的有效性.
- 这些发现突出了DRTT DBS的网络效应,并为改进手术向和预测治疗结果提供了洞察力.
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