背景:多发性硬化症(pwMS)患者的运动准备和执行可能受损。可以使用脑电图(EEG)评估这些神经过程。在一个自定节奏的运动中,EEG信号幅度在运动之前减小(事件相关的去同步,ERD)并在移动后增加(与事件相关的同步,ERS).
目的:与健康对照组(HC)相比,重新评估pwMS中ERD/ERS的变化。
方法:这项单中心研究包括13个pwMS和10个性别/年龄匹配的HC。在右手的两个自步调运动中记录了60通道的EEG:简单的食指伸展任务和更复杂的手指敲击任务。临床变量包括MS类型,性别,年龄,疾病持续时间,残疾,握力,疲劳和注意力表现。EEG变量包括ERD和ERS发作潜伏期,持续时间,和使用两种信号分析方法(基于视觉或自动确定)在五个皮质区域的α和β频带中确定的幅度:左右额中央和中心顶叶区域以及中线区域。神经影像学变量包括四个深部大脑结构的体积(丘脑,壳核,苍白球和尾状核)和相对病变负荷。
结果:仅在β带中观察到与HC相比,pwMS中的ERD/ERS变化。在pwMS中,β-ERD在中线和右侧顶中央区域延迟发作,在顶中央区域持续时间缩短或振幅增加;β-ERD持续时间较短,延迟发作,或在左侧顶/额中央区域的振幅减小。此外,在中线区域具有更延迟的β-ERD的pwMS的执行功能受损较少,但尾状核体积增加,而在运动对侧的顶中央区域具有更延迟的β-ERS的pwMS疲劳较少,但丘脑体积增加。
结论:这项研究证实了pwMS中运动准备和执行的改变,主要特征是β带中的皮质激活延迟(ERD)和运动后抑制(ERS)延迟和减少。这些变化可能涉及补偿机制,将更多保留的临床表现和大脑深部结构的过度激活相关联。
BACKGROUND: Motor preparation and execution can be impaired in patients with multiple sclerosis (pwMS). These neural processes can be assessed using electroencephalography (EEG). During a self-paced movement, EEG signal amplitude decreases before movement (event-related desynchronization, ERD) and increases after movement (event-related synchronization, ERS).
OBJECTIVE: To reappraise ERD/ERS changes in pwMS compared to healthy controls (HC).
METHODS: This single-center study included 13 pwMS and 10 sex/age-matched HC. 60-channel EEG was recorded during two self-paced movements of the right hand: a simple index finger extension task and a more complex finger tapping task. Clinical variables included MS type, sex, age, disease duration, disability, grip strength, fatigue and attentional performance. EEG variables included ERD and ERS onset latency, duration, and amplitude determined using two methods of signal analyses (based on visual or automated determination) in the alpha and beta frequency bands in five cortical regions: right and left frontocentral and centroparietal regions and a midline region. Neuroimaging variables included the volumes of four deep brain structures (thalamus, putamen, pallidum and caudate nucleus) and the relative lesion load.
RESULTS: ERD/ERS changes in pwMS compared to HC were observed only in the beta band. In pwMS, beta-ERD had a delayed onset in the midline and right parietocentral regions and a shortened duration or increased amplitude in the parietocentral region; beta-ERS had a shorter duration, delayed onset, or reduced amplitude in the left parieto/frontocentral region. In addition, pwMS with a more delayed beta-ERD in the midline region had less impaired executive functions but increased caudate nuclei volume, while pwMS with a more delayed beta-ERS in the parietocentral region contralateral to the movement had less fatigue but increased thalami volume.
CONCLUSIONS: This study confirms an alteration of movement preparation and execution in pwMS, mainly characterized by a delayed cortical activation (ERD) and a delayed and reduced post-movement inhibition (ERS) in the beta band. Compensatory mechanisms could be involved in these changes, associating more preserved clinical performance and overactivation of deep brain structures.