Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism

被引：574

作者：

Rosin, Boris ^{[1
,2
]}

Slovik, Maya ^{[1
,2
]}

Mitelman, Rea ^{[1
,2
,3
]}

Rivlin-Etzion, Michal ^{[1
,2
,3
]}

Haber, Suzanne N. ^{[4
]}

Israel, Zvi ^{[2
,5
]}

Vaadia, Eilon ^{[1
,2
,3
,6
]}

Bergman, Hagai ^{[1
,2
,3
,6
]}

机构：

[1] Hebrew Univ Jerusalem, Hadassah Med Assoc, Sch Med,Dept Med Neurobiol Physiol, Inst Med Res Israel Canada, IL-91120 Jerusalem, Israel

[2] Hadassah Univ Hosp, IL-91120 Jerusalem, Israel

[3] Hebrew Univ Jerusalem, Interdisciplinary Ctr Neural Computat, IL-91904 Jerusalem, Israel

[4] Univ Rochester, Dept Pharmacol & Physiol, Sch Med & Dent, Rochester, NY 14642 USA

[5] Hebrew Univ Jerusalem, Hadassah Med Assoc, Sch Med, Ctr Funct & Restorat Neurosurg, IL-91120 Jerusalem, Israel

[6] Hebrew Univ Jerusalem, Edmond & Lily Safra Ctr Brain Sci, IL-91904 Jerusalem, Israel

来源：

NEURON | 2011年 / 72卷 / 02期

关键词：

1-METHYL-4-PHENYL-1,2,3,6-TETRAHYDROPYRIDINE PRIMATE MODEL; PRIMARY MOTOR CORTEX; BASAL GANGLIA; SUBTHALAMIC NUCLEUS; GLOBUS-PALLIDUS; OSCILLATORY ACTIVITY; PATHOLOGICAL SYNCHRONIZATION; MOVEMENT-DISORDERS; NEURONAL-ACTIVITY; FIRING PATTERNS;

D O I：

10.1016/j.neuron.2011.08.023

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Continuous high-frequency deep brain stimulation (DBS) is a widely used therapy for advanced Parkinson's disease (PD) management. However, the mechanisms underlying DBS effects remain enigmatic and are the subject of an ongoing debate. Here, we present and test a closed-loop stimulation strategy for PD in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) primate model of PD. Application of pallidal closed-loop stimulation leads to dissociation between changes in basal ganglia (BG) discharge rates and patterns, providing insights into PD pathophysiology. Furthermore, cortico-pallidal closed-loop stimulation has a significantly greater effect on akinesia and on cortical and pallidal discharge patterns than standard open-loop DBS and matched control stimulation paradigms. Thus, closed-loop DBS paradigms, by modulating pathological oscillatory activity rather than the discharge rate of the BG-cortical networks, may afford more effective management of advanced PD. Such strategies have the potential to be effective in additional brain disorders in which a pathological neuronal discharge pattern can be recognized.

引用

页码：370 / 384

页数：15

共 80 条

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