Kufungazve nezveParkinson's: Pfungwa yeSomato-Cognitive Action Network (SCAN)

Ko kana iri network yezviito zvehuropi inobatanidza kufamba nepfungwa dzinomutsa, muviri wemunhu, uye kukurudzira? Ini ndini Michele Matarazzo mupepeti wepodcast, uye nhasi tichakurukura nezvepepa rezvisikwa richikurudzira izvozvo chaizvo. Nyaya yacho ine musoro unoti Parkinson's Disease as a Somato Cognitive Action Network Disorder. Muenzi wedu ndiProfessor Heshang Liu wekuChangping Laboratory muBeijing, China. Munyori wekupedzisira uye anoenderana nepepa iri. Heshang, tinokugamuchirai kupodcast iyi.

Prof. Hesheng Liu: Mhoroi, ndafara kuva pano. Ndatenda nekusuma.

Dr. Michele Matarazzo: Zvakanaka. Saka ndaizoda kutanga nepfungwa yacho pachayo nekuti inonzwika seyakanaka, asi inogonawo kunzwika seyakangofanana. Vazhinji vedu takatanga kudzidza neuroanatomy kuburikidza ne classic penfield homonculus uye kusvika nguva pfupi yadarika ndiyo yaive musimboti. Asi nguva pfupi yadarika basa rakaburitswa muNature muna 2023, ndinotenda kuti izvi zvakapikisa maonero echinyakare e somatotopic e motor cortex, uye zvakaunza pfungwa ye Somato cognitive Action Network kana SCAN. Mungatitsanangurire kuti chii chinonzi SCAN uye nei chingave chakakosha pachirwere cheParkinson?

Prof. Hesheng Liu: Ehe. SCAN i network ichangobva kuwanikwa iri pakati penzvimbo dze effector motor. Saka kare apo Dr. Penfield vakaona homunculus vachishandisa cortico stimulation. Ehe kana vachikurudzira nzvimbo ye effector, vanoona kupindura kwemaoko, makumbo kana rurimi.

Asi kune nzvimbo dziri pakati penzvimbo idzodzo dzinoshanda. Asi kana ukakurudzira nzvimbo idzodzo, hauoni kufamba kuri pachena kwezvishandiso izvi. Saka zvakashaikwa makore makumi masere apfuura apo Dr. Penfield akakurudzira cortex. Asi uchishandisa tekinoroji yepamusoro ye neuroimaging, ikozvino unogona kuona zvakajeka kuti kune dzimwe nzvimbo dziri dzoga dziripo munzvimbo yemotokari.

Saka mupepa reNature ra2023 apo Gordon nevamwe vake, vakatsanangura matunhu iwayo. Vanotaura kuti matunhu aya ane chekuita nebasa rekuziva, kwete basa rekufamba chete. Saka vanopa zita iri seSomato Cognitive Action Network. Ini ndinofunga kuti ichi chinhu chakanaka kwazvo.

Dr. Michele Matarazzo: Uye kuti munhu wese anzwisise izvi, kunzwisisa kwazvino ndekwekuti nzvimbo iyi inobatanidza zvinoitika kubva pakuona kwemotokari nepfungwa, handiti?

Prof. Hesheng Liu: Ehe ndinofunga kuti ndizvozvo zvishoma. Zvinogona kunge zvichiendesa rumwe ruzivo rwepfungwa kudunhu remota, kudunhu remota re [00:03:00] remazuva ano, kana kuti rine mamwe mabasa akafanana semuenzaniso nekushanda kweautonomic. Pamwe nezvimwe semuenzaniso, kugadzirira ropa, BP yakaderera sezvamuchaona muvarwere veParkinson uye matambudziko ekugaya uye matambudziko ekurara.

Saka zvese izvi zvinogona kunge zvine chekuita nenetwork iyi yeSCAN.

Dr. Michele Matarazzo: Saka zvino usati watanga kunyora nezvepepa racho uye kuongororo yako, sei waifunga kuti iyi network chaiyo yaibatsira kuParkinson's?

Prof. Hesheng Liu: Mubvunzo wakanaka kwazvo. Muna 2016, tanga tichiedza kuziva ma functional circuits anokonzera Parkinson's. Izvi zvave zviri kurota kwevaongorori vazhinji. Ehe, tinoda kuziva, nezvechirwere ichi chakakosha che functional disorder, ndechipi circuit chakakuvadzwa kana kukanganiswa nechirwere ichi?

Saka tanga tichishandisa tekinoroji yekufungidzira inoshanda, tichiedza kuona macircuit aya anoshanda. Asi kutaura chokwadi, hatina kuona chinhu chitsva [00:04:00] kusvika patakaona iyi Nature Paper ya2023. Zvadaro yakatipa kurudziro yakawanda nekuti tinoziva kuti chirwere cheParkinson hachisi chirwere chekufamba chiri nyore, kunyangwe chichigara chichitumidzwa zita kana kutsanangurwa sechirwere chekufamba.

Asi unoziva kuti kana paine moto kana kudengenyeka kwenyika, varwere vanogona kukurumidza kudzoka pabasa ravo rekufamba. Vanogona kutiza panzvimbo iyi. Kufunga nezvepfungwa kune chekuita nemabasa avo ekufamba. Saka ndosaka ndakafunga kuti pamwe chirwere cheParkinson, inyaya yakakura nezvebasa rekufunga uye mashandiro ekufamba kwemuviri.

Uye patakaona bepa reSCAN muna 2023 rakapindura mibvunzo yakawanda pakarepo. Saka zvese zvakatanga kunzwisisika. Takabva taona kuti nzvimbo iyi ingave iri nzvimbo yakatyoka muuropi hwemurwere weParkinson, izvo zvakakanganisa [00:05:00] kubatana kuripo pakati penzvimbo yekufunga nenzvimbo yekufamba kwemuviri.

Saka takatanga nepfungwa iyi. Tobva tadzidza nezvevarwere ivavo uye takaona kuti, ehe, izvozvo, ichokwadi chaizvo.

Dr. Michele Matarazzo: Zvakanaka. Uye ikozvino ndinoda kubvunza mubvunzo wekupedzisira tisati tanyatsoongorora pepa iri ndewekuti, munofunga kuti functional imaging ndiyo here kana kuti fMRI, ndiyo nzira yakanakisisa yekudzidza izvozvo? Kana kuti inoenzaniswa sei ne metabolic imaging, ngatitii semuenzaniso, FDG-PET?

Prof. Hesheng Liu: Saka kune nzira dzakasiyana dzekudzidza network dzeuropi kana nzvimbo dzisina kushanda zvakanaka dzeuropi hwemurwere. Functional MRI ine zvakanakira zvakawanda kupfuura FDG PET maererano nespatial resolution. Uye kune dzimwe nzira, semuenzaniso, electrophysiology yekudzidza neuro circuits kare, idzo vanhu vanga vachinyora chiratidzo cheneurophysiology panguva yeDBS stimulation.

Saka ndiyo imwe nzira yekufungidzira kubatana [00:06:00] pakati penzvimbo dzeuropi. Zvisinei, ndichiri kutenda kuti MRI inoshanda ine mukana wekukupa mufananidzo wakazara weuropi hwese. Uye ikozvino kunyanya neMRI compatible DBS unogona kutodzidza kuti masero europi anopindura sei kusimulation.

Dr. Michele Matarazzo: Zvakakwana. Ndatenda neiyi sumo yakanaka uye pfupiso yedambudziko rekutanga. Zvino ngatitangei nepepa. Pepa racho rakanyanya kuzara nekuti ibasa guru rekushandura. Uye makaunganidza data rakakura kwazvo rine vanhu vakawanda, uye ndinofunga kuti rine vanhu 863 vakatora chikamu mumapoka akati wandei, inova nhamba inoshamisa. Zvino tisati tasvika kune kupindira, ndezvipi zvakawanikwa pakutanga paunoongorora kubatana kwebasa muchirwere cheParkinson tichienzanisa nevanodzora hutano? Uye zvakare, paunoongorora zvinoitika, tarisa SCAN iyi zvakananga?

Prof. Hesheng Liu: Saka chinhu chikuru chakawanikwa ndechekuti [00:07:00] marongerwo emukati memuviri akakosha atinoziva kuti ane chekuita neParkinson's. Semuenzaniso, STN/GPi ne substantia nigra. Marongerwo aya tese tinoziva kuti marongerwo aya akakosha kune Parkinson's uye tinoda kuziva kuti marongerwo aya anobata sei nenzvimbo dzemukati memuviri.

Patinotarisa MRI yekuzorora, takaona kuti maumbirwo ese aya anoratidza kubatana kwakasimba kusingawanzoitiki nenzvimbo yeSCAN mu cortex. Zvichienzaniswa nevanhu vane hutano, Parkinson's yakaratidza kubatana kusingawanzoitiki, zvinoreva kubatana zvakanyanya. Saka ndicho chinhu chinoshamisa chakaonekwa.

Dr. Michele Matarazzo: Saka chaizvoizvo uri kureva kuti zvese izvi zvinangwa zvekurapa zvatave tichishandisa kwemakore, STN, GPI, thalamus, nezvimwewo ndizvo zvaigara zvichichinja SCAN. Isu taisazviziva zvakanaka.

Prof. Hesheng Liu: Ehe. Kare isu [00:08:00] pamwe taifungidzira kuti zvivakwa izvi zve subcortical zvakabatana nenzvimbo yemotor. Saka takatora sezvisingatarisirwi kuti matunhu aya chikamu chemotor circuit. Tinofunga kuti zvakabatana neM1, asi hatimbofa takaongorora zvakarongeka kuti zvivakwa izvi zve subcortical zvinobatana papi uye zvinobuda papi. Tinofungidzira kuti pamwe zvinobuda panzvimbo yeruoko, nzvimbo yetsoka, kana nzvimbo yerurimi.

Asi zvakazoonekwa kuti hapana kana chimwe chazvo chiri chechokwadi. Zvese zviri kuitirwa kunharaunda yeSCAN.

Dr. Michele Matarazzo: Uye zvino kana ndikabvunza, pamwe pangave nevamwe vateereri vedu vasina hunyanzvi mukuongorora mitsipa yeuropi kana mukuongorora mashandiro europi. Unogona kutsanangura here zvaunoreva nekutaura nezve hyperconnectivity?

Prof. Hesheng Liu: Izvi zvinoreva kuti chiratidzo chiri pakati penzvimbo ye cortico SCAN nechiratidzo chiri mumaumbirwo iwayo e subcortical zvakabatana zvakanyanya. Kubatana kwavo kwakanyanya, izvo zvisina kujairika nekuti vanofanirwa kunge vakazvimiririra zvakanyanya. Asi chimwe chinhu chakaitika chakakonzera kuenderana kwakanyanya pakati peaya ma [00:09:00] nuclei akadzika nenzvimbo ye cortical.

Dr. Michele Matarazzo: Zvakakwana. Zvino, chimwe chinhu chakakosha chawataura mupepa, ndechekuti kune matambudziko akawanda anosanganisira shanduko dzemuviri nedzepfungwa. Iye zvino wagadzirisa izvi zvakananga nekusanganisira mamwe mapoka etsinga nemamiriro ezvinhu akadai sekutetemeka kwakakosha nezvimwe zvirwere. Kuenzanisa uku kwakaratidzei?

Prof. Hesheng Liu: Takava nemubvunzo wekuti pane kubatana kwakanyanya pakati peSCAN neaya ma subcortical structures. Chinhu chinowanzoitika kune ese ma pathological disorders. Semuenzaniso, dystonia, essential tremor, uye ALS. Tichifunga nezvemibvunzo iyi, tinoongorora mapoka evarwere ava tovaenzanisa nevarwere vane hutano.

Zvinoshamisa kuti hyperconnectivity yatakaona muvarwere veParkinson haina kuonekwa muvarwere veALS. Kwete muvarwere vane essential tremor. Kwete muvarwere vane dystonia. Saka izvi zvinoratidza kuti hyperconnectivity iyi [00:10:00] inogona kunge iine zvimwe zvinhu zvakanangana neParkinson's. Asi handisi kureva kuti Parkinson's chete ndiyo inogona kuunza hyperconnectivity iyi.

Asi pakati pezvirwere izvi zvakasiyana-siyana zvekufamba, takadzidza kuti chirwere cheParkinson ndicho chega chakaratidza kusagadzikana uku kwakasimba.

Dr. Michele Matarazzo: Uye ungatarisira here kuwana hukama hwakafanana nedzimwe mhando dzeParkinsonism?

Prof. Hesheng Liu: Mubvunzo wakanaka uyu. Tiri kutsvaga mamwe marudzi eParkinson syndrome, MSA kana PSP. Saka ipurojekiti iri kuenderera mberi.

Dr. Michele Matarazzo: Ndiri kutarisira mhinduro. Zvino ngatiendei kumhedzisiro yekurapa yausina kumira pakusarudza phenotype yekufungidzira yawakaongorora kuti inochinja sei nekurapa. Mukati me levodopa, nzira dzakawanda dzekugadzirisa masero, meseji huru yekuti, kurapwa kunoshanda kunoderedza SCAN iyi kuenda ku subcortex hyperconnectivity. Ndedzipi nzira dzakakosha dzawakadzidza, [00:11:00] uye chii chakakupa chivimbo chekuti maitiro aya akasimba pane kuwana kamwe chete?

Prof. Hesheng Liu: Ehe, ndinofunga kuti kurapwa uku kwese kunobatana nekubatana uku kwakanyanya, izvo zvinoshamisa. Kutanga tadzidza nezveDBS nekuti takaunganidza data rakawanda kubva kuvarwere gumi nevana vakarapwa neDBS. Takavaongorora kwemaawa akawanda muMRI. Semuenzaniso, kune murwere wega wega asati aiswa DBS, takaunganidza data rekutanga rezuva rimwe chete.

Uye mushure mekuisirwa, tinoongorora murwere kwemazuva maviri nguva dzose. Ehe, masikati chete. Kana varwere vachinzwa vakasununguka, tinoisa murwere muskena tobva tamutsa tichishandisa maparamita akasiyana. Semuenzaniso, dzimwe nguva tinomutsa ne60 hertz stimulation.

Dzimwe nguva 90 hertz, dzimwe nguva 130 hertz. Dzimwe nguva tinoibatidza toidzima. Dzimwe nguva tinovakurudzira nguva dzose. Pa [00:12:00] murwere wega wega tinovarongera nguva yekuskena kwemazuva maviri. Uye tinodzokorora izvi kashanu mugore rimwe chete. Saka zvinoreva kuti tinoskena murwere wega wega kwemazuva angangoita gumi mushure mekuisirwa.

Saka tinoziva chaizvo kuti DBS inogadzirisa sei mashandiro europi hwemurwere wega wega. Takaona zviitiko zvakafanana zvakafanana pamunhu wese. Saka ndosaka tine chivimbo chakawanda chekuti patinosimudzira STN, takaona kudzikira kwekubatana uku pakati peSCAN neSTN.

Saka ndiyo ruzivo rwakakosha rwekuti mushonga uyu unogamuchirwa zvakanaka. Zvinoita sekunge wakatanga kushanda nekuderedza hyperconnectivity iyi. Uye gare gare tinoedzawo kuona kana mushonga uyu, unova ndiwo mushonga unonyanya kushandiswa nevarwere vese, wakabatsirawo. Takaona chinhu chimwe chete, kuti uchiri kuderedza hyperconnectivity.

Dr. Michele Matarazzo: Izvo zvinonakidza zvikuru. Uye chimwe chinhu [00:13:00] chekukurukura kukosha kwebhendi re beta, iro rinozivikanwa sechiratidzo che electrophysiological cheParkinson's kana Parkinsonism? Zvinobatana sei ne hyperconnectivity iyi?

Prof. Hesheng Liu: Mubvunzo wakanaka kwazvo. Takatora chiratidzo cheEEG kubva kumaelectrodes eDBS. Saka tinoziva kuti patinomutsa uropi uye mashandiro ebhendi rebeta anochinja. Uye kune zvimwe zvidzidzo zvekare zvinoratidza kuwirirana kwakanyanya pakati pecortex nenzvimbo dziri pasi pebhondi rebeta.

Tinotenda kuti kusawirirana uku kwebhendi rebeta pamwe kwakabatana nekudzikira kwekubatana kwatakaona mu fMRI. Asi tinoda humbowo hwakananga.

Dr. Michele Matarazzo: Zvakanaka. Zvino, watotaura nezvedanho rinotevera. Saka takatokurukura nezvekudzidza nezve hyperconnectivity iyi se biomarker. Zvadaro kuti inochinja sei nekurapwa. Asi wakaenda mberi uchiita TMS trial. Saka wakaronga [00:14:00] varwere makumi matatu nevatanhatu vane Parkinson's kuti vapinde mu intermittent theta burst stimulation pamusoro pe SCAN target yakasarudzika kana pamusoro pe effector specific motor target. Uye zviri pachena kuti kutarisa SCAN kunoita sekunge kunounza bhenefiti yakakura yemotor.

Munogona here kutiratidza zvamakakurudzira uye kuti chinangwa chacho chakatsanangurwa sei nemunhu mumwe nemumwe uye kuti chii chakachinja kubva pakuona kwekiriniki?

Prof. Hesheng Liu: Ehe. Saka, tinodzidza varwere makumi matatu nevatanhatu. Takaisa izvozvo mumapoka maviri. Saka boka rimwe chete tinoshandisa functional MRI scan, tobva tashandisa nzira ye network. Saka tave tichigadzira functional network population algorithms mumakore gumi apfuura. Saka ikozvino tine nzira yakapfava yekutsanangura matunhu iwayo.

Saka pamurwere wega wega tinogona kuziva nzvimbo yavo yeSCAN nenzvimbo ine simba. Saka kuboka rekurapwa reSCAN, tichashandisa TMS kukurudzira [00:15:00] chikamu chepakati cheSCAN. Saka kana ukatarisa bepa rezvisikwa ra2023, bepa rekutanga reSCAN, pane nzvimbo nhatu dziri mu gyrus yepamberi pepakati.

Saka yepamusoro inowanzogara mu sulci. Saka haisi nyore kuiwana uchishandisa TMS asi yepakati iri nyore kuiwana neTMS. Saka takasarudza iyoyo. Uye kune boka rekudzora, tinosimudzira nzvimbo ye effector pamusoro penzvimbo iyi yepakati yeSCAN kana pasi penzvimbo yeSCAN.

Saka daro riri pakati pechinangwa cheM1 nechinongedzo cheSCAN ringangove sendimita imwe chete. Asi mhedzisiro yacho yakasiyana zvikuru. Kushanda zvakanaka kuri nani ka2.5 kana uchikurudzira SCAN zvichienzaniswa nekumutsa chinongedzo cheM1. Izvi zvinotiudza kunyangwe munzvimbo yemotokari, kurapwa kweTMS [00:16:00] kunofanirwa kufunga nezvekutarisa kwakanyatsojeka.

Kana ukakwanisa kuona chinangwa cheSCAN chakakodzera, unowana mabhenefiti akawanda. Asi kana ukarasikirwa nesendimita imwe chete unenge wava kure uye unenge uchikurudzira nzvimbo ye effector motor kuti kushanda kwayo kwakaderera zvikuru.

Dr. Michele Matarazzo: Uye zvechokwadi unotaurawo zvakajeka kuti iyi yaive ongororo diki yepakati, asi kungoti uve nechokwadi chekuti vateereri vazive kuti iyi yaive bvunzo isina kujekeswa, handiti.

Prof. Hesheng Liu: Saka varwere nevashandi, havana kuziva kuti ndeupi murwere ari kurapwa neSCAN, ndeupi ari kugamuchira M1?

Dr. Michele Matarazzo: Zvino, dai waironga bvunzo inotevera neizvi, chii chawaizoisa pamberi mhedzisiro yekusarudzwa kwevarwere senge kufamba kana kuomesa kana kuteverwa kwenguva yakareba? Chii chawaizodzidza?

Prof. Hesheng Liu: Saka pari zvino ndine zvidzidzo zvakawanda zviri kuitwa. Imwe ongororo yakafanana neyamakatsanangura yatinoda kutarisa pakufamba nechando. Zviratidzo izvi zvakaoma kurapa kana tichienzanisa nekudedera. Saka zviratidzo izvi hazvigone kudzorwa nemishonga muvarwere vazhinji.

DBS haigone kuidzora, asi muvarwere vedu, kunyangwe nemuenzaniso mudiki, takaona kuti tine mhedzisiro yakanaka padambudziko iri rekufamba. Saka ikozvino tinoda kusarudza vamwe varwere vane matambudziko chaiwo ekufamba nechando. Saka ichocho chidzidzo chimwe chete. Uye chimwe ndechekuti taida kutarisa pane zvimwe zviratidzo zvisiri zvekufamba netsoka.

Semuenzaniso matambudziko ekurara, kugaya chikafu, uye BP yakaderera. Saka tinoda kuona kuti kurapwa kweSCAN kunogona sei kugadzirisa zviratidzo izvozvo.

Dr. Michele Matarazzo: Saka uri kuedzawo kutarisana nezviratidzo zvakaoma kugadzirisa kazhinji nesarudzo dzatiinadzo parizvino.

Prof. Hesheng Liu: Ndinofunga kuti izvi zvinoda simba guru. Uye zvechokwadi tinoda kuita ongororo yenzvimbo dzakasiyana-siyana kuti tisimbise zvatakawana.

Dr. Michele Matarazzo: Zvakakwana. Zvino kune veruzhinji vefocus ultrasound uye ini pachangu, isu [00:18:00] tinoita focus ultrasound yakawanda uye makaongororawo VIM thalamotomy uye makaunza pfungwa inoshanda zvikuru. Kusvika padanho rekukuvara kwacho padanho reSCAN remurwere. Iye zvino makadzidza boka revarwere gumi.

Ungandiudza here zvakaitika ikoko?

Prof. Hesheng Liu: Ichi chidzidzo chekutanga cheMRI guided focused ultrasound lesion study. Saka takakuvadza VIM, iyi thalamic area muvarwere ava vane tremor dominant. Uye takaona kuvandudzika mune vamwe varwere, uye vamwe varwere havasi kupindura zvakanaka. Saka mushure memakore angangoita matatu ikozvino tine fungidziro yakasimba yekuti iyi SCAN circuit ndiyo core circuit yeParkinson's.

Tinotarisa zvinangwa zvepakutanga zvemaronda kuti tione kana paine chatingawana uye tinoona kuti kana ukakuvadza nzvimbo yakabatana ne cortico SCAN, [00:19:00] unoona mhinduro yakasimba muvarwere ivavo. Asi kana usina kunyatsoshanda zvakanaka, kushanda zvakanaka kwacho kwakaipa.

Saka zvinoita sekunge inyaya yakasimba pakati pedaro riri pakati peSCAN sweet spot. Uye maitiro atinoita. Saka ndinofunga kuti mune ramangwana, pamwe tinogona kuita functional MRI scan yevarwere tisati taita focus ultrasound lesion, tobva taziva sweet spot iri muthalamus tobva taita lesion munzvimbo iyoyo izvo zvinogona kuwedzera kushanda kwayo.

Dr. Michele Matarazzo: Saka chirevo chakakura ndechekuti tinogona kuchinja zvishoma nezvishoma kubva pakubatanidzwa kwemaatomuki kuenda kune zvinangwa zvakatsanangurwa nedunhu nenzira yakasarudzika, uye tichiri mukati methalamus, asi tichitungamirirwa nekubatana kwebasa remurwere mumwe chete, handiti?

Prof. Hesheng Liu: Ehe. Saka ndiyo pfungwa yacho, ndinofunga nekuti thalamus imhando hombe. Zvino kana ukaita chironda nenzira yechinyakare, uri kuzviita nenzira yekuedza nekukanganisa. Asi ikozvino kana uchigona kushandisa functional circuit kuti ikutungamirire unogona kuona mhedzisiro iri nani [00:20:00].

Dr. Michele Matarazzo: Zvakakwana. Zvino regai ndiende kumibvunzo miviri yakakosha pamwe nemibvunzo yakaoma. Chekutanga, munofunga kuti hyperconnectivity inokonzera here, mhinduro yekutsiva, kana chiratidzo chekuchinja kwezvirwere kuri kuitika muParkinson's? Uye humbowo hupi hunogona kunyepa kana kutsigira pfungwa yeSCAN senzira huru kwete chiratidzo chete?

Prof. Hesheng Liu: Saka maonero angu panyaya iyi inyaya yechikonzero kwete nzira yekutsiva. Chikonzero ndechekuti kana iri nzira yekutsiva, varwere vanowana kubatana kwakanyanya. Inogona kunge iine mashandiro emuviri akavandudzwa. Saka ndizvo zvinoreva kutsiva.

Asi hatizvioni izvozvo. Kutaura chokwadi takaona kuti kana ukarapa varwere neDBS kana mamwe marapirwo, kuvandudzwa kwebasa remaitiro kunoenderana nekudzikira kwe [00:21:00] kwekubatana kwakanyanya, zvinoenda nenzira imwe chete.

Saka pane kutaura zvinopesana, handiti? Saka ndosaka ndichifunga kuti zvingangoita kuti pave nechikonzero. 

Dr. Michele Matarazzo: Ndingawedzerawo mumwe mubvunzo pamusoro pekuti, kana hyperconnectivity iyi iriyo chikonzero chezvinoitika kuchirwere cheParkinson uye chechirwere chacho, pamwe, hamufungi here kuti kurapwa uku kwese kunochinja nekuderedza hyperconnectivity iyi, hamufungi here kuti kunofanira kuva nemigumisiro yekuchinja chirwere pachirwere.

Prof. Hesheng Liu: Ehe. Ehe. Mubvunzo wakanaka kwazvo. Ndinofunga kuti tese tinotenda kuti kurasikirwa nedopamine neuron ndiko kunokonzera kuunganidzwa kweiyi alpha synuclein. Saka ndinotenda kuti shanduko idzi dikidiki muuropi dzichatungamira kushanduko huru dzedunhu rinoshanda. Zvisinei, kuderedza kubatana pachako, kungave kuri kuchinja chirwere kana kwete, ndinofunga hazvisi kuratidza zvakananga [00:22:00] kuti kuderedza kubatana kuri kuchinja chirwere. Zvichida ndiko kudzora zviratidzo. Zvisinei, kukurudzira SCAN, ini pachangu ndinotenda kuti iri kuchinja maitiro echirwere.

Ndine humbowo hweizvozvo, kwete mupepa rino, asi ndine zvinhu zvakati wandei zvandinoda kutaura kuitira kuti murwere wangu wekutanga wandakarapa makore akati wandei apfuura tinorapa murwere uyu kakawanda mwedzi mitanhatu yega yega tinomurapa kwemavhiki maviri, uye takaona kuti maitiro echirwere akachinjwa.

Murwere wacho apera kumeso kwake neParkinson. Uye mishonga yake inodzikira ne60 kusvika 70%, izvo zvisingawanzoitiki. Kazhinji mushure memakore akati wandei, unoona varwere vava kutora mishonga yakawanda pane kushoma, uye mashandiro emuviri wemurwere anovandudzika zvikuru. Saka pandakamurapa kekutanga makore akati wandei apfuura, aisagona kufamba [00:23:00] ari ega, asi iye zvino ari kutamba anenge mazuva ese mukirasi yake yekutamba. Uye aitogona kutoenda kuEurope. Saka unogona kuona kuti zvachinja.

Uye takaitawo zvidzidzo zvemhuka. Takaona izvi zvakajeka mumuenzaniso wedu wembeva, kana ukakurudzira SCAN unoona kuti kunyangwe mushure mekumisa kukurudzira, mashandiro emhuka anoramba achivandudzwa. Izvi zvinoreva kuti haufanirwe kuita kukurudzira kunoenderera mberi seDBS uye uchiri kuona kuvandudzwa kwebasa remota.

Asi DBS, kana ukakurudzira maumbirwo aya e subcortical, hauoni mhedzisiro yakawanda yekuchinja chirwere. Saka kunyangwe mushure memakore akati wandei ekurapwa kweDBS, kana ukadzima simulator zviratidzo zvinodzoka nekukurumidza, handiti? Saka mhedzisiro yakasiyana kwazvo yatakaona mukukurudzirwa kwecortex uye kukurudzirwa kwe subcortical.

Dr. Michele Matarazzo: Izvi zvinonakidza zvikuru. Ehe, tichada kuona rumwe ruzivo nezveizvi uye pfungwa idzi dzese dzinonakidza zvikuru. Ngationei kuti ndedzipi ruzivo rwamuchatiratidza mune ramangwana. Ndichasvika pane imwe yemibvunzo yekupedzisira, iyo ndeyekuti, makatondiudza kuti muri kuronga uye muri kutoita zvimwe zvidzidzo, kunyanya kutarisa zviratidzo zvakasiyana zveParkinson's. Asi kana maifanira kufungidzira, ndeapi ma domain ezviratidzo amunotarisira kuti anonyanya kubatana neSCAN?

Prof. Hesheng Liu: Ini ndinofunga kuti pamwe ibasa rekufamba uye mabasa e autonomic. Saka izvozvo zvinofambiranawo zvakanaka nepfungwa yekutanga yebasa reSCAN mupepa ra2023. Gordon et al., vakataura kuti network idzi dzingangodaro dziri kugadzirisa mabasa e autonomic.

Saka ndinotenda kuti ndiyo nzira chaiyo yekufamba nayo.

Dr. Michele Matarazzo: Mubvunzo wekupedzisira ndewekuti, kana chiremba wezvirwere zvekufamba akatora meseji imwe kubva mupepa iri, inofanira kuva yei?

Prof. Hesheng Liu: Saka, kare Parkinson's yaitsanangurwa zvichibva pazviratidzo zve [00:25:00]. Idambudziko rekufamba, asi ikozvino tava kuziva mashandiro echirwere ichi. Saka ikozvino tsananguro yacho yawedzerwa kumatambudziko eSCAN nekuti tinoziva chaizvo kuti chii chinotyoka muchirwere ichi.

Dr. Michele Matarazzo: Zvakakwana. Uye ndinofunga kuti ishoko rakakodzera nguva nekuti tiri kukurukura zvakawanda munguva pfupi yapfuura nezvekuchinja chirwere cheParkinson kubva patsanangudzo yekiriniki kuenda kutsanangudzo yebhayoloji, uye kuisa tsananguro yenetwork mumutambo pano kunoita kuti zvese zvive zvakaoma, asi zvinonakidzawo. Zvino Heshang ndatenda zvikuru. Pepa iri rinopa fungidziro chaiyo yekuchinja Parkinson's, kwete seti yezviratidzo, asi sezvamakataura, sekusagadzikana kwedanho renetwork, neSCAN hyperconnectivity sechiratidzo chinobatanidza uye chinangwa chinogona kuita kuti neuromodulation inopinda uye isingapindike ive yakanyatsojeka.

Ndatenda zvikuru nekundibatana.

Prof. Hesheng Liu: Ndafara. Ndatenda.

 [00:26:00]