Temporal Investigations of the Changes in Presynaptic Inhibition Associated With Subthalamic Nucleus Deep-Brain Stimulation
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Background and Purpose There are controversies regarding the role of presynaptic inhibition (PSI) in the mechanisms underlying the efficacy of deep-brain stimulation (DBS) in Parkinson’s disease (PD). We sought to determine the involvement of PSI in DBS-related mechanisms and clinical correlates. Methods We enrolled PD subjects who had received subthalamic nucleus DBS (STN-DBS) therapy and had been admitted to our clinic between January 2022 and March 2022. The tibial H-reflex was studied bilaterally during the medication-off state, and all tests were repeated 10 and 20 minutes after the simulation was turned off. Simultaneous evaluations based on the Movement-Disorder-Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS-III) were performed in all of the patients. Results Ultimately we enrolled 18 patients aged 58.7±9.3 years (mean±standard deviation, 10 females). Fifty percent of the patients showed a decrease in the MDS-UPDRS-III score of more than 60% during the stimulation-on period. Comparative analyses of the repeated measurements made according to the stimulation status revealed significant differences only in the left H-reflex/M-response amplitude ratio (H/M ratio). However, no difference in the left H/M ratio was found in the subgroup of patients with a prominent clinical response to stimulation (n=9). Analyses of the less-affected side revealed differences in the H-reflex amplitude and H/M ratio. Conclusions We found evidence of PSI recovery on the less-affected side of our PD subjects associated with STN-DBS. We hypothesize that the involvement of this spinal pathway and its contribution to the mechanisms of DBS differ between individuals based on the severity of the disease and which brainstem regions and descending tracts are involved.
Abstract
Background and Purpose There are controversies regarding the role of presynaptic inhibition (PSI) in the mechanisms underlying the efficacy of deep-brain stimulation (DBS) in Parkinson’s disease (PD). We sought to determine the involvement of PSI in DBS-related mechanisms and clinical correlates. Methods We enrolled PD subjects who had received subthalamic nucleus DBS (STN-DBS) therapy and had been admitted to our clinic between January 2022 and March 2022. The tibial H-reflex was studied bilaterally during the medication-off state, and all tests were repeated 10 and 20 minutes after the simulation was turned off. Simultaneous evaluations based on the Movement-Disorder-Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS-III) were performed in all of the patients. Results Ultimately we enrolled 18 patients aged 58.7±9.3 years (mean±standard deviation, 10 females). Fifty percent of the patients showed a decrease in the MDS-UPDRS-III score of more than 60% during the stimulation-on period. Comparative analyses of the repeated measurements made according to the stimulation status revealed significant differences only in the left H-reflex/M-response amplitude ratio (H/M ratio). However, no difference in the left H/M ratio was found in the subgroup of patients with a prominent clinical response to stimulation (n=9). Analyses of the less-affected side revealed differences in the H-reflex amplitude and H/M ratio. Conclusions We found evidence of PSI recovery on the less-affected side of our PD subjects associated with STN-DBS. We hypothesize that the involvement of this spinal pathway and its contribution to the mechanisms of DBS differ between individuals based on the severity of the disease and which brainstem regions and descending tracts are involved.
참고문헌 (33)
- Morita H, "Decrease in presynaptic inhibition on heteronymous monosynaptic Ia terminals in patients with Parkinson’s disease", Mov Disord, 15, pp.830~834 (2000)
- de Andrade EM, "Spinal cord stimulation for Parkinson’s disease : a systematic review", Neurosurg Rev, 39, pp.27~35 (2016)
- Raudino F, "Involvement of the spinal cord in Parkinson’s disease", Int J Neurosci, 122, pp.1~8 (2012)
- Sabbahi M, "Methods of H-reflex evaluation in the early stages of Parkinson’s disease", J Clin Neurophysiol, 19, pp.67~72 (2002)
- Silva-Batista C, "Resistance training with instability is more effective than resistance training in improving spinal inhibitory mechanisms in Parkinson’s disease", J Appl Physiol(1985), 122, pp.1~10 (2017)
- Mohamed N. Thabit, "Altered Spinal Excitability in Patients with Primary Fibromyalgia: A Case-Control Study", Journal of Clinical Neurology, 17(1), pp.121~127 (2021), 대한신경과학회
- Teigland OH, "Utility of the H-reflex in diagnosing polyneuropathy", Muscle Nerve, 60, pp.424~428 (2019)
- Martinelli P, "Conditioning of the H reflex by stimulation of the posterior tibial nerve in Parkinson’s disease", J Neurol Neurosurg Psychiatry, 42, pp.701~704 (1979)
- Andrews JC, "Intraoperative changes in the H-reflex pathway during deep brain stimulation surgery for Parkinson’s disease : a potential biomarker for optimal electrode placement", Brain Stimul, 13, pp.1765~1773 (2020)
- Parmentier É, "Correlation between deep brain stimulation effects on freezing of gait and audio-spinal reflex", Clin Neurophysiol, 129, pp.2083~2088 (2018)
- Raoul S, "Subthalamic nucleus stimulation reverses spinal motoneuron activity in parkinsonian patients", Brain, 135(Pt 1), pp.139~147 (2012)
- Onder H, "Investigation of the changes in the presynaptic inhibition in association with the subthalamic nucleus stimulation in Parkinson’s disease", Neurol Res, 44, pp.969~974 (2022)
- Pötter M, "The effect of subthalamic nucleus stimulation on autogenic inhibition in Parkinson disease", Neurology, 63, pp.1234~1239 (2004)
- Preston DC, "Electromyography and Neuromuscular Disorders" (2013), Elsevier
- Kushnir M, "H reflex behavior in Parkinson’s disease patients. Effect of stimulus duration", Parkinsonism Relat Disord, 6, pp.243~246 (2000)
- Kleiner-Fisman G, "Long-term follow up of bilateral deep brain stimulation of the subthalamic nucleus in patients with advanced Parkinson disease", J Neurosurg, 99, pp.489~495 (2003)
- McLeod JG, "H reflex studies in patients with Parkinson’s disease", J Neurol Neurosurg Psychiatry, 35, pp.77~80 (1972)
- Daniel S, "L-dopa effects on H-reflex recovery in Parkinson’s disease", Ann Neurol, 2, pp.120~124 (1977)
- Rye DB, "Medullary and spinal efferents of the pedunculopontine tegmental nucleus and adjacent mesopontine tegmentum in the rat", J Comp Neurol, 269, pp.315~341 (1988)
- Pahapill PA, "The pedunculopontine nucleus and Parkinson’s disease", Brain, 123(Pt 9), pp.1767~1783 (2020)
- Homma Y, "Effects of pedunculopontine nucleus(PPN)stimulation on caudal pontine reticular formation(PnC)neurons in vitro", J Neurophysiol, 87, pp.3033~3047 (2002)
- Devos D, "Dopaminergic and non-dopaminergic pharmacological hypotheses for gait disorders in Parkinson’s disease", Fundam Clin Pharmacol, 24, pp.407~421 (2010)
- Chambers NE, "Pedunculopontine nucleus degeneration contributes to both motor and non-motor symptoms of Parkinson’s disease", Front Pharmacol, 10, pp.1494~ (2020)
- Moro E, "Response to levodopa in parkinsonian patients with bilateral subthalamic nucleus stimulation", Brain, 125(Pt 11), pp.2408~2417 (2002)
- Moro E, "Unilateral pedunculopontine stimulation improves falls in Parkinson’s disease", Brain, 133(Pt 1), pp.215~224 (2010)
- Li M, "Oscillations in pedunculopontine nucleus in Parkinson’s disease and its relationship with deep brain stimulation", Front Neural Circuits, 9, pp.47~ (2015)
- Agari T, "Spinal cord stimulation for the treatment of abnormal posture and gait disorder in patients with Parkinson’s disease", Neurol Med Chir(Tokyo), 52, pp.470~474 (2012)
- Samotus O, "Spinal cord stimulation therapy for gait dysfunction in advanced Parkinson’s disease patients", Mov Disord, 33, pp.783~792 (2018)
- Stefani A, "Bilateral deep brain stimulation of the pedunculopontine and subthalamic nuclei in severe Parkinson’s disease", Brain, 130(Pt 6), pp.1596~1607 (2007)
- Khan S, "Combined pedunculopontine-subthalamic stimulation in Parkinson disease", Neurology, 78, pp.1090~1095 (2012)
- Pinto de Souza C, "Spinal cord stimulation improves gait in patients with Parkinson’s disease previously treated with deep brain stimulation", Mov Disord, 32, pp.278~282 (2017)
- Fonoff ET, "Spinal cord stimulation for freezing of gait : from bench to bedside", Front Neurol, 10, pp.905~ (2019)
- Herrington TM, "Mechanisms of deep brain stimulation", J Neurophysiol, 115, pp.19~38 (2016)