机构：[1]Department of Neurology, Neurobiology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute for Brain Disorders, Beijing, China神经科系统内科系统神经内科老年医学科首都医科大学宣武医院神经生物学研究室[2]National Clinical Research Center for Geriatric Disorders, Beijing, China[3]Pacific Parkinson’s Research Centre, University of British Columbia, Vancouver, Canada[4]Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada[5]Department of Electronic Science and Technology, University of Science and Technology of China, Hefei, China[6]Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China[7]Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China医技科室放射科首都医科大学宣武医院[8]Clinical Center for Parkinson’s Disease, Capital Medical University, Beijing, China[9]Key Laboratory for Neurodegenerative Disease of the Ministry of Education, Beijing Key Laboratory for Parkinson’s Disease, Beijing, China[10]Department of Medicine (Neurology), University of British Columbia, Vancouver, Canada
Robust, effective treatments for Parkinson's freezing of gait remain elusive. Our previous study revealed beneficial effects of high-frequency rTMS over the supplementary motor area. The present study aims to explore the neural mechanisms of rTMS treatments utilizing novel exploratory multivariate approaches. We first conducted a resting-state functional MRI study with a group of 40 Parkinson's disease patients with freezing of gait, 31 without freezing of gait, and 30 normal controls. A subset of 30 patients with freezing of gait (verumgroup:N = 20;shamgroup:N = 10) who participated the aforementioned rTMS study underwent another scan after the treatments. Using the baseline scans, the imaging biomarkers for freezing of gait and Parkinson's disease were developed by contrasting the connectivity profiles of patients with freezing of gait to those without freezing of gait and normal controls, respectively. These two biomarkers were then interrogated to assess the rTMS effects on connectivity patterns. Results showed that the freezing of gait biomarker was negatively correlated with Freezing of Gait Questionnaire score (r = -0.6723,p < 0.0001); while the Parkinson's disease biomarker was negatively correlated with MDS-UPDRS motor score (r = -0.7281,p < 0.0001). After the rTMS treatment, both the freezing of gait biomarker (0.326 +/- 0.125 vs. 0.486 +/- 0.193,p = 0.0071) and Parkinson's disease biomarker (0.313 +/- 0.126 vs. 0.379 +/- 0.155,p = 0.0378) were significantly improved in theverumgroup; whereas no significant biomarker changes were found in theshamgroup. Our findings indicate that high-frequency rTMS over the supplementary motor area confers the beneficial effect jointly through normalizing abnormal brain functional connectivity patterns specifically associated with freezing of gait, in addition to normalizing overall disrupted connectivity patterns seen in Parkinson's disease.
基金：
National Key R&D Program of China [2018YFC1312001, 2017YFC0840105, 2017YFC1310200]; Beijing Municipal Administration of Hospitals' Mission Plan [SML20150803]; Beijing Municipal Science & Technology CommissionBeijing Municipal Science & Technology Commission [Z171100000117013]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [61473196]; Beijing Talents Foundation [2016000021223TD07]; UBC/PPRI Chair in Parkinson's Disease Research
第一作者机构：[1]Department of Neurology, Neurobiology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute for Brain Disorders, Beijing, China[2]National Clinical Research Center for Geriatric Disorders, Beijing, China[3]Pacific Parkinson’s Research Centre, University of British Columbia, Vancouver, Canada
通讯作者：
推荐引用方式(GB/T 7714)：
Mi Tao-Mian,Garg Saurabh,Ba Fang,et al.Repetitive transcranial magnetic stimulation improves Parkinson's freezing of gait via normalizing brain connectivity[J].NPJ PARKINSONS DISEASE.2020,6(1):doi:10.1038/s41531-020-0118-0.
APA：
Mi, Tao-Mian,Garg, Saurabh,Ba, Fang,Liu, Ai-Ping,Liang, Pei-Peng...&McKeown, Martin J..(2020).Repetitive transcranial magnetic stimulation improves Parkinson's freezing of gait via normalizing brain connectivity.NPJ PARKINSONS DISEASE,6,(1)
MLA：
Mi, Tao-Mian,et al."Repetitive transcranial magnetic stimulation improves Parkinson's freezing of gait via normalizing brain connectivity".NPJ PARKINSONS DISEASE 6..1(2020)
