Aborting an ongoing motor response (response inhibition) is controlled through a complex network, critically involving the hyper-direct pathway from supplementary motor area to the subthalamic nucleus (STN) [1]. Logan and Cowan first described the Stop Signal Reaction Time (SSRT), a measure of stopping efficiency [2]. Since then SSRT has been investigated in various neurological disorders. Parkinson’s disease (PD) patients have deficient response inhibition, which is independent of the severity of bradykinesia [3]. Levodopa and bilateral STN deep brain stimulation (DBS) both improve response inhibition in Parkinson’s patients [4,5]. Recently, our group has developed a portable device to measure reaction time and response inhibition, which is easy to use at the bedside or in the clinic. We have also introduced an improvedmeasure (optimum combination SSRT; ocSSRT) which uses a Bayesian statistical approach to enhance reproducibility [5]. In this pilot study we recruited Parkinson’s patients from our movement disorders clinic, and compared ocSSRT with standard bedside clinical assessments during optimisation of bilateral STN-DBS parameters. We included 16 patients with STN-DBS (Medtronic Activa stimulators), in whom DBS electrodes had been implanted at least six months prior to optimisation. All patients reported motor complaints with existing programming, and attended clinic to optimize simulation parameters using the N’vision 8840 physician programmer. Measurements of Movement Disorder SocietyUnified Parkinson’s disease Rating Scale Part III (MDS-UPDRS III, Motor score for PD patients) and ocSSRT were made three times: with the initial DBS setting (when the patients hadmotor symptoms), after turning off the DBS and lastly after reprogramming, when both programmer and subject felt that the settings were optimal. The ocSSRT box has a screen to display instructions and test results. A green and red LED act as the go and stop cues respectively (Fig. 1A). Patients started a trial by pressing and holding a button. They were told to release this quickly if the green LED illuminated (go trial), but to keep the button pressed if the red LED illuminated (stop trial). Responses to 192 trials were recorded (inter-trial interval 1e2.638s), in three blocks of 64 trials separated by a 60 s rest. Within each block, there were 48 go trials and 16 stop trials. The stop trials presented the red LED at four different delays (5e195 ms) after the green LED. The device measured the distribution of reaction times in the go trials, and the proportion of stop

中文翻译：

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使用便携式设备测量的停止信号反应时间验证了最佳 STN-DBS 编程

中止正在进行的运动反应（反应抑制）是通过一个复杂的网络来控制的，关键是涉及从辅助运动区到丘脑底核 (STN) 的超直接通路 [1]。Logan 和 Cowan 首先描述了停止信号反应时间 (SSRT)，这是一种衡量停止效率的指标 [2]。从那时起，SSRT 在各种神经系统疾病中得到了研究。帕金森病 (PD) 患者的反应抑制不足，这与运动迟缓的严重程度无关 [3]。左旋多巴和双侧 STN 深部脑刺激 (DBS) 均可改善帕金森病患者的反应抑制 [4,5]。最近，我组开发了一种便携式设备，用于测量反应时间和反应抑制，易于在床边或诊所使用。我们还引入了一种改进措施（最佳组合 SSRT；ocSSRT），它使用贝叶斯统计方法来提高可重复性 [5]。在这项初步研究中，我们从我们的运动障碍诊所招募了帕金森病患者，并在优化双侧 STN-DBS 参数期间将 ocSSRT 与标准床边临床评估进行了比较。我们纳入了 16 名 STN-DBS（美敦力 Activa 刺激器）患者，这些患者在优化前至少已植入 DBS 电极六个月。所有患者都报告了现有编程的运动问题，并前往诊所使用 N'vision 8840 医师编程器优化模拟参数。运动障碍协会统一帕金森病评定量表第 III 部分（MDS-UPDRS III，PD 患者的运动评分）和 ocSSRT 进行了 3 次测量：使用初始 DBS 设置（当患者出现运动症状时）、关闭 DBS 后和最后重新编程后，程序员和受试者都认为设置是最佳的。ocSSRT 框有一个屏幕来显示说明和测试结果。绿色和红色 LED 分别作为开始和停止提示（图 1A）。患者通过按住按钮开始试验。他们被告知，如果绿色 LED 亮起（开始试用），则迅速松开按钮，但如果红色 LED 亮起（停止试用），则要保持按下按钮。记录了对 192 次试验的反应（试验间间隔 1e2.638s），在由 60 秒休息隔开的 64 次试验的三个块中。在每个区块内，有 48 次去试验和 16 次停止试验。停止试验在绿色 LED 之后的四个不同延迟 (5e195 ms) 显示红色 LED。