非周期性成分对帕金森病丘脑底核局部场电位分析的影响及其生理学意义  

The influence of aperiodic components on the analysis results of subthalamic nucleus local field potential in Parkinson's disease and its physiological significance

作　　者：王著勇 彭椿凯 孙语佳 胡凯 莫诒向 李青青 张世忠[1] 薛杉[1] Wang Zhuyong;Peng Chunkai;Sun Yujia;Hu Kai;Mo Yixiang;Li Qingqing;Zhang Shizhong;Xue Shan(Department of Functional Neurosurgery,Center for Neurosurgery,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China)

机构地区：[1]南方医科大学珠江医院神经外科中心功能神经外科,广州510282

出　　处：《中华神经外科杂志》2024年第4期361-366,共6页Chinese Journal of Neurosurgery

摘　　要：目的探讨非周期性成分对帕金森病(PD)患者丘脑底核(STN)局部场电位(LFP)分析结果的影响及其在运动症状评估中的生理学意义。方法回顾性分析南方医科大学珠江医院神经外科中心功能神经外科2019年2月至2021年9月收治的27例行双侧STN脑深部电刺激治疗的PD患者,其中21例置入传统脉冲发生器,6例置入新型脉冲发生器。采集术中、术后(仅6例置入新型脉冲发生器患者)1~6个月的STN-LFP。采用统一PD评定量表第三部分(包括震颤症状、僵硬症状、运动迟缓症状评分及三种运动症状评分之和)评估术前及术后的肢体运动症状。采用神经元功率谱参数化的方法获得STN-LFP的原始频谱、拟合频谱、原始平坦频谱、拟合平坦频谱4种频谱的β功率值及提取非周期性成分(后2种频谱分别为前2种频谱去除非周期性成分所得),分析非周期性成分与肢体运动症状评分的相关性;将PD患者分为运动不能型(12例)和震颤为主型(15例),绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),分析4种频谱的β功率值鉴别PD运动亚型的效能;分析不同频谱在不同频带的功率值与肢体运动症状评分的相关性。结果27例患者术中LFP的非周期性成分与术前肢体运动症状评分均无相关性(均P>0.05)。6例置入新型脉冲发生器的患者术后随访时间[M(IQR)]为2.00(2.75)个月,术后LFP的非周期性成分与术后肢体运动症状评分均无相关性(均P>0.05)。ROC曲线结果显示,4种频谱的β功率值依上述次序鉴别PD运动亚型的AUC分别为0.69、0.67、0.84、0.89;拟合平坦频谱的分类效能优于拟合频谱(Z=1.86,P=0.033)和原始频谱(Z=1.67,P=0.041),差异均有统计学意义。术中及术后LFP的不同频谱的功率值在不同频带与肢体运动症状评分均有一定的相关性(均P<0.05)。结论尽管非周期性成分本身和肢体运动症状评分无相关性,但其影响PD患者STN-LFP的频谱分析结Objective To investigate the effect of aperiodic components on the results of local field potential(LFP)analysis of the subthalamic nucleus(STN)in patients with Parkinson's disease(PD)and its physiological significance in the assessment of motor symptoms.Methods A total of 27 PD patients with bilateral STN deep brain stimulation admitted to the Department of Functional Neurosurgery,Center for Neurosurgery,Zhujiang Hospital,Southern Medical University from February 2019 to September 2021 were retrospectively analyzed,of whom 21 were implanted with a classical pulse generator,and 6 were implanted with a novel pulse generator.Intraoperative and postoperative(only 6 patients implanted with the novel pulse generator)STN-LFP were collected from 1 to 6 months.Preoperative and postoperative limb motor symptoms were assessed using the third part of the Unified Parkinson's Disease Rating Scale,which included symptom scores for tremor,rigidity,and bradykinesia,as well as the sum of the three motor symptom scores.The neuronal power spectrum parameterization method was used to obtain the power values of the β-band of the original,fited,original flat,and fitted flat spectra of the four spectra of the STN-LFP and the extracted aperiodic components(the aperiodic components,with the last two spectra obtained by removing the aperiodic components from the first two spectra,respectively),and to analyze the correlation between the aperiodic components and the motor symptoms.The patients with PD were classified into 2 motor subtypes:akinetic type(12 cases)and tremor-dominant type(15 cases).The receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to analyze the efficiency of the four spectrum identification of PD motor subtypes.The correlation between electrophysiological characteristics of different frequency bands of the 4 spectra and the motor symptoms was also analyzed.Results No correlation was found between the aperiodic component of intraoperative LFP and the preoperative limb

关 键 词：帕金森病 丘脑底核 局部场电位 非周期性成分 

分 类 号：R742.5[医药卫生—神经病学与精神病学]