首页> 外文期刊>Clinical EEG and neuroscience: official journal of the EEG and Clinical Neuroscience Society (ENCS) >Deep brain stimulation of pedunculopontine tegmental nucleus (PPTg) promotes cognitive and metabolic changes: a target-specific effect or response to a low-frequency pattern of stimulation?
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Deep brain stimulation of pedunculopontine tegmental nucleus (PPTg) promotes cognitive and metabolic changes: a target-specific effect or response to a low-frequency pattern of stimulation?

机译:大脑对pedunculopontine被盖核(PPTg)的刺激会促进认知和代谢变化:目标特异性效应或对低频刺激模式的反应?

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摘要

Deep brain stimulation (DBS) is a reliable treatment for advanced Parkinson's disease (PD) patients, but a possible risk of worsening cognitive functions, although modest, may postpone or halt DBS clinical indication. In a small cohort of PD patients we have pioneered the simultaneous implantation of both the subthalamic nucleus (STN) and the pedunculopontine tegmental nucleus (PPTg). Here we describe the cognitive test performance and the corresponding cortical metabolic activity, as assessed through 18-fluorodeoxyglucose (FDG)-positron emission tomography (PET), of these six PD patients tested in PPTg-ON vs- PPTg-OFF condition. PPTg-ON condition (at low frequency, 25 Hz) induced better performance in tests exploring both executive and attentive domains, which were coupled with an increased glucose utilization in prefrontal and frontal bilateral cortical areas, including both lateral (i.e., BA9) and more antero-medial cortices (BA 25-32). Moreover, during PPTg-ON, a surprising increase of FDG consumption was also observed in the left ventral striatum. These data are consistent with the hypothesis of a positive effect of 25 Hz PPTg-DBS on PD patients' cognitive profile, probably due to a facilitatory effect exerted by PPTg on both associative and limbic pathways.
机译:深部脑刺激(DBS)是晚期帕金森病(PD)患者的可靠治疗方法,但是认知功能恶化的可能风险(尽管适度)可能会推迟或停止DBS临床适应症。在一小部分PD患者中,我们率先同时植入了丘脑下核(STN)和足小弓骨被盖核(PPTg)。在这里,我们描述了这六名在PPTg-ON与PPTg-OFF条件下测试的PD患者的认知测试性能和相应的皮质代谢活性,通过18-氟脱氧葡萄糖(FDG)-正电子发射断层扫描(PET)进行了评估。 PPTg-ON条件(在低频,25 Hz下)在探索执行域和注意域的测试中表现出更好的性能,并且在前额和额叶双侧皮质区域(包括外侧区域(即BA9)等)中的葡萄糖利用率增加前内侧皮质(BA 25-32)。此外,在PPTg-ON期间,在左腹纹状体中也观察到了FDG消耗的惊人增加。这些数据与25 Hz PPTg-DBS对PD患者的认知状况有积极作用的假设相符,这可能是由于PPTg对结缔组织和边缘途径都发挥了促进作用。

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