Clinical Neurophysiology最新文献_第4页

Elevated body mass index in youth is associated with neural disinhibition and internetwork functional dysconnectivity: A magnetoencephalography study 青少年身体质量指数升高与神经去抑制和网络间功能连接障碍有关：一项脑磁图研究

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-08 DOI: 10.1016/j.clinph.2025.2111476

A.C. Reichelt , E. Daskalakis , J. Cohen , K.G. Solar , M. Saberi , M. Ventresca , M. Ali , R. Zamyadi , V. Bhat , S.E. Scratch , J. Hamilton , B.T. Dunkley

Objective

The developing brain has a vulnerability to the negative impact of obesity and excessive consumption of hyperpalatable foods. Animal models suggest changes in the excitation:inhibition balance of the brain in obesogenic diets, including disinhibition and hyperexcitability, and altered connectivity between brain regions.

Methods

We investigated the neurophysiological effects of overweight and obesity in 32youth (8–19 years), using a naturalistic viewing protocol with magnetoencephalography (MEG). Subjects were recruited into two groups based on normalised / z-scored body mass index (zBMI), a < 1 SD group (n = 15) and ≥ 1 SD group (n = 17). We assessed spontaneous oscillatory activity and aperiodic components (spectral exponent and offset) and network functional connectivity.

Results

Elevated zBMI was associated with significant increases in gamma activity, as well as a reduced exponent and offset across multiple regions, which suggest changes in neural excitation and inhibition. Additionally, we observed low frequency hypoconnectivity and high frequency hyperconnectivity between multiple brain networks.

Conclusions

These findings underscore the neural impact of body composition on the developing brain, suggesting deleterious alterations in excitation and inhibition and brain networks linked with cognition and behaviour.

Significance

These alterations may contribute to the persistent behavioural rigidity and difficulties in adopting healthier eating behaviours into adulthood.

目的发育中的大脑容易受到肥胖和过度食用美味食物的负面影响。动物模型表明，在致肥性饮食中，大脑的兴奋：抑制平衡发生了变化，包括去抑制和高兴奋性，以及大脑区域之间连接的改变。方法采用自然观察脑磁图（MEG）方法，对32例8 ~ 19岁青少年超重和肥胖的神经生理影响进行研究。根据标准化/ z评分的体重指数（zBMI）将受试者分为两组，1 SD组（n = 15）和≥1 SD组（n = 17）。我们评估了自发振荡活动和非周期成分（谱指数和偏移）以及网络功能连通性。结果zBMI升高与γ活性显著升高相关，且多个区域的指数和偏移量降低，提示神经兴奋和抑制发生变化。此外，我们观察到多个大脑网络之间的低频低连通性和高频超连通性。这些发现强调了身体组成对发育中的大脑的神经影响，表明与认知和行为相关的兴奋和抑制以及大脑网络的有害改变。这些改变可能导致持续的行为僵化和成年后难以采用更健康的饮食行为。

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引用次数: 0

Cerebellar repetitive transcranial magnetic stimulation attenuates essential tremor by modulating visuomotor network connectivity 小脑重复性经颅磁刺激通过调节视运动网络连接来减弱特发性震颤

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-07 DOI: 10.1016/j.clinph.2025.2111472

Xue Shi , Runyang He , Lin Zhu , Nan Yan , Shaoxia Fan , Zian Pei , Xiaolin Su , Fali Li , Yumei Liu , Ge Dang , Shuhan Fan , Peng Xu , Dezhong Yao , Robert Chen , Yi Guo

Objective

To investigate the neurophysiological mechanisms underlying cerebellar repetitive transcranial magnetic stimulation (rTMS) in essential tremor (ET) using source-level electroencephalography (EEG) phase-locking value analysis.

Methods

EEG recordings and clinical assessments of ET patients (n = 20) before and after 4-week bilateral cerebellar rTMS were studied and evaluated for correlations. Brain source activities were reconstructed using standardized low-resolution brain electromagnetic tomography (LORETA). Functional connectivity and local network metrics in the alpha band (8–13 Hz) were compared with those of healthy controls (n = 20).

Results

ET patients had lower nodal efficiency in visual areas and reduced inter-regional occipital connectivity than controls. Local network metrics in the left superior occipital gyrus, left cuneus, and right fusiform gyrus negatively correlated with tremor severity and significantly improved with rTMS. Connectivity changes between the left inferior occipital gyrus (IOG) and superior parietal gyrus (SPG) and the right SPG and midcingulate cortex (MCC), strongly correlated with improvements in activities of daily living. Performance-related connectivity changes involved the left IOG-SPG, right SPG-MCC, and left middle occipital gyrus to the supplementary motor area.

Conclusions

Cerebellar rTMS may alleviate ET by reorganizing functional connectivity within the visuomotor network.

Significance

Our findings provide preliminary mechanistic insights and potential biomarkers for ET treatment, pending validation in future sham-controlled studies.

目的通过源级脑电图（EEG）锁相值分析，探讨小脑重复经颅磁刺激（rTMS）治疗特发性震颤（ET）的神经生理机制。方法对20例ET患者（n = 20）双侧小脑rTMS前后4周的seeg记录和临床评价进行研究，并评价相关性。采用标准化低分辨率脑电磁断层扫描（LORETA）重建脑源活动。将α波段（8-13 Hz）的功能连通性和局部网络指标与健康对照（n = 20）进行比较。结果与对照组相比，set组患者视觉区节效率较低，枕叶区域间连通性较差。左侧枕上回、左侧楔叶和右侧梭状回的局部网络指标与震颤严重程度呈负相关，rTMS显著改善了震颤严重程度。左侧枕下回（IOG）和顶叶上回（SPG）以及右侧SPG和中扣带皮层（MCC）之间的连通性变化与日常生活活动的改善密切相关。与表现相关的连通性变化包括左眼动脑区、右眼动脑区和左枕中回至辅助运动区。结论小脑rTMS可能通过重组视觉运动网络内的功能连接来缓解ET。我们的发现为ET治疗提供了初步的机制见解和潜在的生物标志物，有待于未来的假对照研究的验证。

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引用次数: 0

Auditory-evoked changes in slow oscillations and spindles correlate with memory consolidation in children with epilepsy and controls 听觉诱发的慢振荡和纺锤波的变化与癫痫和控制儿童的记忆巩固有关。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-07 DOI: 10.1016/j.clinph.2025.2111475

Hunki Kwon , Dhinakaran M. Chinappen , Anirudh Wodeyar , Elizabeth A. Kinard , Skyler K. Goodman , Wen Shi , Bryan S. Baxter , Dara S. Manoach , Mark A. Kramer , Catherine J. Chu

Objective

We investigated the effects of auditory stimulation during sleep on slow oscillations (SOs), SO-spindle complexes, and sleep-dependent memory consolidation in children with Rolandic Epilepsy (RE) and controls.

Methods

Participants completed two nap visits with auditory or sham stimulation. SOs and SO-spindle complexes rates were measured offline using validated detectors. Sleep-dependent memory consolidation was assessed using the motor sequence typing task.

Results

Auditory stimulation evoked SOs and SO-spindle complexes with maximal effect over frontal electrodes. Compared to sham, stimulation of background activity increased SOs (29.8 %, p < 0.001) and SO-spindle complexes (16.8 %, p < 0.001); stimulation of an ongoing SO upstate maximally evoked SOs (51.3 % increase, p < 0.001) and SO-spindle complexes (32.3 % increase, p < 0.001). Changes in frontal SO (1.9 % improvement per increase in SO/min; p < 0.001) and SO-spindle complexes (9.5 % improvement per increase in SO-spindle/min; p = 0.007) event rates due to auditory stimulation positively predicted changes in sleep-dependent memory consolidation.

Conclusion

Auditory stimulation reliably modulates sleep oscillations when delivered on background activity and during the upstate of SOs. As increased event rates improve memory consolidation, stimulation paradigms to increase SO and SO-spindle complex rates are required to enhance memory.

Significance

Auditory stimulation paradigms that increase SO and SO-spindle complex rates may enhance sleep-dependent memory consolidation.

目的：探讨睡眠时听觉刺激对罗兰dic癫痫（RE）患儿及对照组慢振荡（so）、慢梭形复合体和睡眠依赖性记忆巩固的影响。方法：参与者在听觉或假刺激下完成两次午睡访问。使用经过验证的检测器离线测量SOs和so纺锤体配合物速率。通过运动序列输入任务评估睡眠依赖性记忆巩固。结果：听觉刺激诱发的SOs和so纺锤体复合物在额电极上的作用最大。与假手术相比，背景活动刺激增加了SOs（29.8%）。结论：听觉刺激在背景活动和SOs上状态时可靠地调节睡眠振荡。由于增加的事件率促进记忆巩固，因此需要增加SO和SO-纺锤体复合体率的刺激范式来增强记忆。意义：听觉刺激范式增加梭形和梭形纺锤体复合体速率可能促进睡眠依赖性记忆巩固。

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引用次数: 0

Diagnostic utility of clinical neurophysiology in Wilson's disease with hyperkinetic movements. 临床神经生理学对伴多动运动的威尔逊氏病的诊断价值。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-06 DOI: 10.1016/j.clinph.2025.2111471

Alban Gravier, Mickael Alexandre Obadia, Jean-Luc Thibault, Christine Delmaire, Aurélia Poujois, Nathalie Kubis

Objective: Movement disorders (MD) are frequent in Wilson's disease (WD). Surface electromyography (sEMG) with accelerometry is commonly used to analyze hyperkinetic MD, as clinical examination may be insufficiently sensitive. We present here the first neurophysiological description of MD in WD patients to: (1) assess the sensitivity of neurophysiology relative to clinical evaluation; (2) correlate MD diagnosed by neurophysiology with the biological and radiological data of patients.

Methods: WD patients with hyperkinetic MD not fully characterized by clinical examination alone were included from December 2012 to December 2021. Clinical, biological, brain MRI and neurophysiology evaluations were conducted at inclusion and during follow-up.

Results: We included 12 WD patients (3.9 % of the total cohort, and 11 % of the patients with neurological complications). During follow-up, neurophysiological evaluation identified 10 patients as having either isolated or combined tremors (seven postural, six resting, four orthostatic, four functional, two kinetic and one dystonic tremors), and five myoclonus. Four cases of pseudo orthostatic tremors, five of myoclonus and two functional tremors were not detected clinically. Action tremor on sEMG was the only MD significantly associated with a mild-to-moderate midbrain FLAIR hypersignal.

Conclusion: Postural and resting tremors were the most frequent MD, whereas myoclonus was the most frequent MD that had remained clinically uncharacterized and diagnosed at neurophysiological evaluation.

Significance: This study emphasizes the undeniable added value of neurophysiological evaluation in these patients.

目的：运动障碍（MD）是威尔逊氏病（WD）的常见病。表面肌电图（sEMG）与加速度计通常用于分析多运动性肌萎缩症，因为临床检查可能不够敏感。我们在此提出WD患者MD的第一个神经生理学描述：(1)评估神经生理学相对于临床评估的敏感性；(2)将神经生理学诊断的MD与患者的生物学和放射学资料联系起来。方法：纳入2012年12月至2021年12月期间未单独临床检查完全特征的WD伴多动性MD患者。在纳入和随访期间进行临床、生物学、脑MRI和神经生理学评估。结果：我们纳入了12例WD患者（占总队列的3.9%，11%的患者有神经系统并发症）。在随访期间，神经生理学评估确定了10例患者为孤立性或合并性震颤（7例体位性震颤，6例静息性震颤，4例直立性震颤，4例功能性震颤，2例运动性震颤和1例肌张力障碍震颤）和5例肌阵挛。假性直立性震颤4例，肌阵挛性震颤5例，功能性震颤2例，临床未检出。肌电图上的行动性震颤是唯一与轻度至中度中脑FLAIR高信号显著相关的MD。结论：体位性和静息性震颤是最常见的MD，而肌阵挛是最常见的MD，在临床未被诊断为神经生理评估。意义：本研究强调了神经生理评估在这些患者中的不可否认的附加价值。

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引用次数: 0

Modulation of corticospinal excitability by paired associative stimulation following stroke 脑卒中后成对联想刺激对皮质脊髓兴奋性的调节

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-06 DOI: 10.1016/j.clinph.2025.2111474

Alona Ron Levy , Iuly Treger , Uri Alyagon , Tatiana Gulevsky , Noam Ygael , Amit Hiedemann , Olga Nachliely , Orna Kohav , Judith S. Nosgorodsky , Alan Friedman , Lena Lutsky , Jechil S. Sieratzki , Abraham Zangen

引用次数: 0

Diagnostic muscle ultrasound and ultrasound-guided needle electromyography in quadrilateral space syndrome 肌肉超声和超声引导针肌电图诊断四边形间隙综合征。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-04 DOI: 10.1016/j.clinph.2025.2111470

Cameron S. Smock , Jessica N. Buttinger , Marianne T. Luetmer , Amy S. Beacom , Joaquin Sanchez-Sotelo , James B. Meiling

引用次数: 0

Postoperative epileptiform discharges predict seizure outcomes in pediatric low-grade developmental and epilepsy associated tumors 术后癫痫样放电预测小儿低度发育性和癫痫相关肿瘤的发作结局

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-04 DOI: 10.1016/j.clinph.2025.2111462

Florian Mayer , Johannes Zielke , Birgit Pimpel , Katharina Moser , Clara Köller , Sarah Glatter , Gregor Kasprian , Amedeo A. Azizi , Johannes Gojo , Matthias Tomschik , Christian Dorfer , Karl Roessler , Martha Feucht

Objective

To assess the prognostic value of interictal epileptiform discharges (iEDs) on postoperative video-EEG in children and adolescents undergoing epilepsy surgery for low-grade developmental and epilepsy-associated tumors (LEATs).

Methods

This retrospective single-center study analyzed prospectively collected pre- and postoperative EEG data from pediatric LEAT patients. Associations between iED characteristics and seizure outcomes ≥ 24 months after surgery were examined.

Results

Fifty-nine patients with a median postoperative follow-up of 59.0 months (IQR: 36.0–118.0) were included. Univariate analysis identified the presence of a secondary iED focus at 3 months (p = 0.04), persistent iEDs at 12 months (p = 0.007), and a ≥ 50 % increase in iED frequency over time (p = 0.009) as predictors of unfavorable seizure outcomes. Multivariate analysis confirmed that a ≥ 50 % increase in iED frequency within the first 12 months post-surgery was independently associated with unfavorable outcomes (OR: 16.2, 95 % CI: 1.2–555.0, p = 0.037).

Conclusions

Postoperative iEDs, particularly their evolution over time, are valuable predictors of long-term seizure outcomes following LEAT surgery.

Significance

Prognostic models for seizure outcomes in LEAT patients should not only include clinical, radiological and surgical characteristics, but also presence and progression of iEDs in postoperative EEGs.

目的探讨癫痫样放电（ied）对儿童和青少年癫痫手术后低级别发育性和癫痫相关肿瘤（LEATs）的预后价值。方法回顾性单中心研究前瞻性分析小儿LEAT患者术前和术后的脑电图数据。检查iED特征与术后≥24个月癫痫发作结果之间的关系。结果纳入59例患者，术后中位随访59.0个月（IQR: 36.0 ~ 118.0）。单因素分析发现，3个月时继发iED灶（p = 0.04）、12个月时持续iED （p = 0.007）以及iED频率随时间增加≥50% （p = 0.009）是不良癫痫发作结果的预测因素。多因素分析证实，术后前12个月内iED频率增加≥50%与不良结果独立相关（OR: 16.2, 95% CI: 1.2-555.0, p = 0.037）。结论术后ied，特别是其随时间的变化，是LEAT手术后长期癫痫发作结局的重要预测指标。LEAT患者癫痫发作结局的预后模型不仅应包括临床、放射学和外科特征，还应包括术后脑电图中ied的存在和进展。

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引用次数: 0

Detecting emotion in individuals with disorders of consciousness: a pilot study of heart rate deceleration on affective auditory stimuli 意识障碍患者的情绪检测：情感性听觉刺激下心率减速的初步研究

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-03 DOI: 10.1016/j.clinph.2025.2111469

Hugo Ardaillon , Anne Dubois , Kate-Mary Ndocko , Jérôme Etienne , Catherine Tallon-Baudry , Jacques Luauté

Objective

To evaluate heart rate deceleration on affective auditory stimulations as an objective marker of purposeful affective behaviour, as used in the diagnosis of minimally conscious state (MCS) in brain-injured individuals with disorders of consciousness (DoC), awake but unable to communicate.

Methods

We recorded the heart rate of participants (14 healthy controls and 10 brain injured individuals, conscious or with DoC) on repeated exposure to a random sequence of three emotional sounds of neutral, positive, and negative valence, in an unconditioned manner (experiment 1) or in a trace-conditioning procedure (experiment 2), with successful trace-conditioning assumed to indicate consciousness.

Results

In experiment 1, heart rate deceleration after aversive acoustic stimulus was significantly higher in healthy subjects at the group level from the second to the seventh inter-beat interval, with limited sensitivity at the individual level. In experiment 2, there was no evidence of trace-conditioned learning in healthy subjects, precluding any extrapolation to brain-injured individuals.

Conclusions

Heart rate deceleration after aversive acoustic stimulus was significant in passive hearing but not in a trace-conditioning paradigm and was of limited sensitivity at the individual level.

Significance

Heart rate deceleration may constitute an objective marker of purposeful affective behaviour triggered by emotional sounds. The question of whether this response is a reflex or a marker of conscious access needs further study.

目的评价情感性听觉刺激引起的心率减速作为有目的情感性行为的客观指标，在意识障碍（DoC）脑损伤患者的最低意识状态（MCS）诊断中的应用。方法：我们记录了参与者（14名健康对照者和10名有意识或有DoC的脑损伤者）在重复以无条件方式（实验1）或痕迹条件反射程序（实验2）随机序列暴露于中性、积极和消极三种情绪声音时的心率，假设成功的痕迹条件反射表明意识。结果在实验1中，健康受试者在第2 ~ 7次心跳间隔时，厌恶声刺激后的心率减速度在组水平上显著提高，但在个体水平上敏感性有限。在实验2中，没有证据表明在健康受试者中存在追踪条件学习，排除了对脑损伤个体的任何推断。结论厌声刺激后的心率减慢在被动听力中显著，但在痕迹条件反射模式中不明显，在个体水平上敏感性有限。意义心率减速可能是由情绪声音触发的有目的的情感行为的客观标志。这种反应是一种反射还是一种有意识接触的标志，这个问题需要进一步研究。

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引用次数: 0

Neural signatures of central auditory aging under sensory and cognitive loads 感觉和认知负荷下中枢听觉老化的神经特征

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-03 DOI: 10.1016/j.clinph.2025.2111465

Yifat Yaar-Soffer , Brilliant Brilliant , Chava Muchnik , Andrej Kral , Yael Henkin

Objective

To investigate the neural mechanisms underlying auditory processing in older adults (OAs) under conditions of sensory-perceptual (S-P) and auditory-cognitive (A-C) loads.

Methods

Electroencephalography was recorded in 20 OAs (mean age = 69.6 ± 5.2 years) with age-appropriate hearing and preserved cognition, and 20 younger adults (YAs) (mean age = 24.9 ± 1.8 years). Participants performed tasks under S-P load (quiet vs. noise), A-C load (simple vs. demanding task), and combined load. Analyses included event-related potentials and time-frequency representations.

Results

OAs showed delayed early (N1) and late (P3) cortical responses and slower reaction times (RTs) compared to YAs. Increased alpha-band desynchronization emerged as an age-related biomarker, reflecting OAs’ reduced ability to inhibit irrelevant information. Distinct load-specific processing strategies appeared: S-P load was associated with delayed neural responses across cortical stages, longer RTs, and delta- and theta-band activity. A-C load was associated with prolonged late (P3) cortical activity, slower RTs, and broader neural recruitment across all frequency bands. Under combined load, OAs showed P3 latency prolongation, revealing vulnerability to the dual challenge of noise suppression and cognitive demand.

Conclusion

Integrated time- and frequency-domain electroencephalography analyses exposed distinct listening strategies in OAs, characterized by load-specific neural signatures.

Significance

Improved understanding of auditory processing strategies in OAs will advance targeted auditory rehabilitation.

目的探讨老年人在感觉-知觉（S-P）和听觉-认知（A-C）负荷下听觉加工的神经机制。方法对20例听力正常、认知功能完好的老年患者（平均年龄69.6±5.2岁）和20例青壮年（平均年龄24.9±1.8岁）进行脑电图记录。参与者在S-P负载（安静vs.噪音）、A-C负载（简单vs.苛刻任务）和组合负载下执行任务。分析包括事件相关电位和时频表示。结果与YAs相比，soas的早期（N1）和晚期（P3）皮质反应延迟，反应时间（RTs）减慢。α波段不同步增加是一种与年龄相关的生物标志物，反映了oa抑制无关信息的能力降低。出现了不同的负荷特异性加工策略：S-P负荷与皮层阶段延迟的神经反应、较长的RTs以及δ和θ波段活动有关。A-C负荷与延长的晚期（P3）皮质活动、较慢的RTs和更广泛的所有频带神经募集相关。在复合负荷下，OAs表现出P3潜伏期延长，表明易受到噪声抑制和认知需求的双重挑战。综合时间和频域脑电图分析揭示了oa患者不同的听力策略，其特征是负载特异性神经特征。意义提高对听力加工策略的认识，有助于促进针对性的听力康复。

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引用次数: 0

The role of electrode placement in subthalamic nucleus deep brain stimulation for improving gait in Parkinson’s Disease 在丘脑下核深部脑刺激中电极放置对改善帕金森病步态的作用。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-02 DOI: 10.1016/j.clinph.2025.2111468

Zhongke Mei , Anna-Sophie Hofer , Christian Baumann , Mechtild Uhl , Navrag Singh , William R. Taylor , Lennart Stieglitz , Deepak K. Ravi

Objective

To investigate the relationship between the spatial location of active electrode contacts in subthalamic nucleus deep brain stimulation (STN-DBS) and changes in gait performance in patients with Parkinson’s disease (PwPD).

Methods

This observational study included 49 PwPD who underwent bilateral STN-DBS. Spatiotemporal gait parameters were assessed before surgery and six months post-implantation using motion capture. Both mean values and variability of gait parameters were analyzed. Active contact locations were normalized using a voxel-based approach and statistically associated with gait outcomes.

Results

STN-DBS led to significant reductions in stride time, stance time, swing time, and step time, alongside increased step width and temporal gait variability. Gait improvements were associated with specific stimulation sites: the postero-superior STN region was most effective for enhancing mean spatial parameters (e.g., stride length, walking speed), while the antero-superior region was optimal for reducing temporal variability. Patients stimulated in these regions showed significantly better gait outcomes than those stimulated elsewhere.

Conclusions

Gait improvements were differentially associated with the spatial location of stimulation electrode within the STN, suggesting region-specific modulation of mean spatial and temporal variability gait parameters.

Significance

These findings support precision targeting of stimulation sites to optimize patient-specific gait outcomes, advancing personalized DBS therapy in Parkinson’s disease.

目的：探讨丘脑下核深部脑刺激（STN-DBS）活动电极触点空间位置与帕金森病（PwPD）患者步态变化的关系。方法：本观察性研究纳入49例行双侧STN-DBS的PwPD患者。在手术前和植入后6个月使用动作捕捉技术评估时空步态参数。分析步态参数的平均值和变异性。主动接触位置使用基于体素的方法归一化，并与步态结果统计相关。结果：STN-DBS导致步幅时间、站立时间、摇摆时间和步幅时间显著减少，同时步幅宽度和时间步态变异性增加。步态的改善与特定的刺激部位有关：后上STN区域对提高平均空间参数（例如步幅长度、步行速度）最有效，而前上区域对减少时间变异性最有效。在这些区域受到刺激的患者比在其他地方受到刺激的患者表现出明显更好的步态结果。结论：步态改善与刺激电极在STN内的空间位置存在差异，表明步态参数的平均空间和时间变异性存在区域特异性调节。意义：这些发现支持精确定位刺激部位以优化患者特异性步态结果，推进帕金森病的个性化DBS治疗。

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引用次数: 0