期刊
NEUROLOGY
卷 74, 期 9, 页码 743-748出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e3181d31e0b
关键词
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资金
- Ministry of Education, Culture, Sports, Science, and Technology of Japan [18590928, 16500194]
- Ministry of Health, Labor and Welfare of Japan [17231401]
- Research Committee on Dystonia
- Ministry of Health, Labor and Welfare of Japan
- Committee of the Study of Human Exposure
- Ministry of Internal Affairs and Communications
- Fukushima Medical University
- National Eye Institute Intramural Research
- Ministry of Internal Affairs and Communications/Committee of the Study of Human Exposure
- Grants-in-Aid for Scientific Research [16500194, 18590928] Funding Source: KAKEN
Objectives: The basal ganglia (BG) play an important role in controlling saccades. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is widely used as a treatment of Parkinson disease (PD) by altering the function of the BG. Nevertheless, the effects of STN DBS on saccade performance are not fully clarified in a systematic manner. In this study, we examined the effects of bilateral STN DBS on both the initiation and inhibition of saccades in PD. Methods: Thirty-two patients with PD performed 4 oculomotor tasks. Two tasks (visually guided saccades and gap saccades) were reflexive and 2 (memory-guided saccades [MGS] and antisaccades) were volitional. While taking their regular doses of antiparkinsonian drugs, patients performed these tasks under 2 conditions: during DBS (DBS-on condition) and without DBS (DBS-off condition). Fifty-one age-matched subjects served as controls. Results: In the DBS-on condition, parameters of saccade initiation were improved in all tasks, with shorter latencies and increased amplitudes, except for MGS latency. STN DBS improved the ability to suppress unwanted saccades to the cue stimulus in the MGS task. However, it did not suppress prosaccades during the antisaccade task. Conclusions: These results suggest that deep brain stimulation (DBS) of the subthalamic nucleus (STN) affects the neural pathway common to both reflexive and volitional saccades, possibly by acting on the STN-substantia nigra pars reticulata-superior colliculi pathway. STN DBS may set the functional level of the superior colliculi appropriate for both saccade initiation and inhibition through this pathway. These findings provide novel insights into the pathophysiology of Parkinson disease and may yield better treatment strategies. Neurology (R) 2010; 74: 743-748
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