帕金森病震颤的神经振荡与脑连接偶联机制研究

Deep brain stimulation (DBS) has become an effective treatment of tremor, which is a main and common symptom of Parkinson's disease (PD). However, the mechanisms of PD tremor and DBS remain unclear. Previous functional magnetic resonance (fMRI) studies suggest that the basal ganglia and cerebellar circuits may regulate the onset and amplitude of PD tremor respectively, yet without direct electrophysiological evidence. This study tends to apply local field potential recording from the subthalamic nucleus and globus pallidus to provide electrophysiological information, which is coupled with EMG acceleration sensor, to identify PD tremor-related neural oscillations; secondly, fMRI coupling EMG acceleration sensor is used, to observe the correlation between the local spontaneous neuronal activity and the tremor onset or amplitude, to uncover the role of basal ganglia in PD tremor; finally, functional connectivity analysis is performed to investigate tremor related neural circuits. We hypothesized that PD tremor related neural oscillation in the basal ganglia may be related to the amplitude and/or the onset of tremor. This study may help the understanding of the mechanism of PD tremor, and may provide a theoretical basis for the development of novel neural modulation approach.

震颤是帕金森病（PD）主要且常见的症状，脑深部电刺激（DBS）是其有效治疗手段，但PD震颤以及DBS的机制尚不明确。既往功能磁共振研究提示，基底节和小脑环路可能分别调节PD震颤的起始和幅度，但仍缺乏直接可靠的电生理证据。本研究拟用局部场电位偶联肌电图加速度感应器，记录丘脑底核、苍白球内侧部局部场电位信号，分析不同神经振荡活动与震颤的相关性；其次，通过功能磁共振偶联肌电图加速度感应器，观察相应记录点自发神经活动与震颤起始或幅度的关系，评估基底节在PD震颤中的作用；此外，通过功能连接分析，观察PD震颤的神经环路。我们假设：基底节内存在PD震颤相关的神经振荡活动，可能与震颤的幅度和/或起始相关，该神经振荡活动脑区与小脑环路存在功能连接。本研究有望发现PD震颤的机制，为临床上PD震颤的神经调控模式研发提供理论依据，具有重要的研究和应用前景。

震颤是帕金森病（Parkinson’s disease ,PD）主要且常见的症状，脑深部电刺激（Deep brain stimulation,DBS）是其有效治疗手段，但DBS对PD的调控机制尚不明确，既往功能磁共振研究提示，纹状体-丘脑-皮层环路和小脑-丘脑-皮层环路环路可能分别调节PD震颤的起始和幅度，但仍缺乏直接可靠的电生理证据。本研究纳入震颤为主型PD患者50人，非震颤型PD患者53人，通过测量丘脑底核和苍白球内侧部局部场电位信号，发现震颤为主型PD患者STN内β振荡的功率谱密度(power spectrum density，PSD)显著低于非震颤组；通过对患者肌电图进行震颤频率分析，发现震颤分析可辅助PD的鉴别诊断；通过功能磁共振记录相应记录点神经自发活动，发现PD震颤患者小脑后叶的神经自发活动增高，通过功能连接分析发现齿状核-小脑后叶功能连接增强，齿状核-前额叶皮层功能连接减弱；此外，本研究应用最新的超高场强磁共振观察震颤患者的颅脑MRI改变特点。上述研究有助于PD的鉴别诊断，明确PD震颤的神经环路及机制，为临床上PD震颤的神经调控新模式探索提供理论依据。