deep brain stimulation eye movements reveal anomalous effects of electrode placement and stimulation脑深部电刺激眼球运动显示异常的影响电极位置和刺激.pdfVIP

Deep Brain Stimulation: Eye Movements Reveal Anomalous Effects of Electrode Placement and Stimulation Chrystalina A. Antoniades1,3*, Philip Buttery2,5, James J. FitzGerald4,5, Roger A. Barker2,5, Roger H. S. Carpenter3, Colin Watts4,5 1 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom, 2 Department of Neurology, Addenbrooke’s Hospital, Cambridge, United Kingdom, 3 Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom, 4 Department of Neurosurgery, Addenbrookes Hospital, Cambridge, United Kingdom, 5 Cambridge Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom Abstract One of the major difficulties in evaluating the efficacy of deep brain stimulation (DBS), or understanding its mechanism, is the need to distinguish the effects of stimulation itself from those of the lesion inevitably created during surgery. Recent work has shown that DBS of the subthalamic nucleus in Parkinson’s disease greatly reduces the time it takes the eyes to make a saccade in response to a visual stimulus. Since this saccadic latency can be rapidly and objectively measured, we used it to compare the effects of surgery and of stimulation. We used a saccadometer to measure the saccadic latencies of 9 DBS patients (1) preoperatively, (2) the day after insertion of subthalamic nucleus electrodes, (3) three weeks later, prior to turning on the stimulator, and (4) after commencement of stimulation. Patients were on their anti-Parkinsonian medication throughout the study. It revealed an entirely unexpected and puzzling finding. As in previous studies an amelioration of symptoms is seen immediately after surgery, and then a further improvement when finally the stimulator is turned on, but in the case of saccadic latency the pattern is different: surgery produces a transient increase in latency, re