摘要
目的:在丘脑底核(STN)电刺激治疗帕金森病术 中,应用微电极(MER)记录、分析针道沿途各核团电生理学 特性,确认STN内各亚区范围、边界及STN与周围结构的边 界并制图,为提高靶点定位的精确度提供依据.方法:STN电 刺激术治疗帕金森病30例,植入刺激电极45个.在影像学定 位基础上,应用MER记录、分析各核团细胞电信号的波形、频 率、幅值、背景噪声,有无诱发放电、微刺激反应,所获数据结 合CT/MRI资料,参考Schaltenbrand Wahren脑图谱行针道制 图,描画STN内部运动亚区和非运动亚区范围、边界及STN 与周围结构的边界,确定最终理想靶点.结果:记录131个针 道并制图,平均每个针道记录时间20min,每植入1个刺激电 极需记录2.91个针道.STN细胞电信号为高频、高幅及背景 噪声较高的簇状放电,平均放电频率(49±13)Hz,平均细胞 密度(5.8±1.4)个/mm,上。
AIM: To improve the precision of targeting in surgery of the deep brain stimulation of subthalamic nucleus (STN) to ameliorate the symptoms of Parkinson's disease by recording neurophysiological characteristics of encountered cells along microelectrode trajectories and mapping motor and nonmotor territory of STN using microelectrode recording techniques. METHODS: From November 1999 to April 2004, 30 patients with Parkinson's disease underwent the surgery of deep brain stimulation and 45 electrodes were implanted into the STN. Indirected spiral CT scan imaging-based anatomic targeting was used. Microelectrode recording mapping techniques were employed and the cellular activity was analyzed for various neurophysiologcal parameters, including firing patterns, firing rate, interspike intervals, background noise, evoked potential and reactions to microstimulation. Imagings of CT/MRI preoperative and Schaltenbrand and Wahren atlas were overlapped, so as to identify the motor and nonmotor territory of STN and line out the boundary with adjacent nucleus. Thus, the functional targeting of STN and the optimal place of electrode implant were precisely located. RESULTS: One hundred and thirty one microelectrode recording trajectories and mappings were accomplished. The average microelectrode recording time for each trajectory was 20 min, with a mean of 2.91 trajectories/electrode. Recordings from the STN exhibited an increase in the background activity and an irregular firing pattern, with a mean rate of (49±13) Hz. The mean cell density was ( 5.8±1.4) cells /mm, with an average length from upper bounder to lower bounder of (5.8±0.8) mm. The movement-related cells were located primarily in the dorsolateral sector of the STN, with the leg area located medial along the mediolateral axis and centrally along the anteroposterior axis, compared with the arm area. Tremor-synchronized cells can also be recorded and identified. The target change rate was 89%. CONCLUSION: Application of microelectrode recording mapping techni
出处
《第四军医大学学报》
北大核心
2005年第2期133-136,共4页
Journal of the Fourth Military Medical University
关键词
帕金森病
微电极
脑深部电刺激术
丘脑底核
Parkinson's disease
microelectrode recording
deep brain stimulation
subthalamic nucleus
