目的:应用直流电核团毁损术毁损帕金森病(PD)大鼠模型的内侧苍白球(GPi),记录其手术前后脑电生理活动的变化,以探讨内苍白球射频毁损术治疗PD的可能机制。方法:成年SD大鼠随机分为GP毁损组、假手术组及正常组。对PD毁损组和假手术组大...目的:应用直流电核团毁损术毁损帕金森病(PD)大鼠模型的内侧苍白球(GPi),记录其手术前后脑电生理活动的变化,以探讨内苍白球射频毁损术治疗PD的可能机制。方法:成年SD大鼠随机分为GP毁损组、假手术组及正常组。对PD毁损组和假手术组大鼠采用6-羟基多巴胺(6-OHDA)右侧黑质致密部(SNc)、中脑腹侧被盖区(VTA)两点注射法建立PD大鼠模型,并经腹腔注射阿扑吗啡(APO)诱发旋转以对模型建立进行评价。通过多导联宏电极在体脑电生理记录技术对各组大鼠进行右侧(注射侧)大脑皮层M1、M2区脑电及纹状体场电位的连续24小时记录,同时进行视频录像。对GP毁损组大鼠行直流电GPi毁损术,术后4天对各组大鼠均行阿扑吗啡诱导旋转行为检验,继续记录脑电活动,记录数据经频率谱分析及相干分析以揭示各记录位点信号的频率成分以及不同位点神经元集群间的功能连接和同步性。结果:对GP毁损组大鼠毁损术前后在清醒静息状态下的皮层脑电和纹状体场电位有明显改变,术后HVSs(High Voltage Spindles)在持续时间上明显缩短发作次数明显减少;对各组大鼠术后在静息状态下的脑电信号进行对比,GP毁损组大鼠较假手术组的HVSs持续时间和发作频率均减少并接近正常组大鼠水平,相干性分析显示GP毁损组大鼠术后在HVSs频段(5-13Hz)上的相干程度显著小于假手术组。结论:在清醒静息状态下6-OHDA建立的PD大鼠皮层-基底节环路上HVSs持续时间延长发生频率增高,经GP毁损术后其时间缩短发作次数减少同步性降低并接近正常水平,从而改善PD症状,该现象可能解释临床采用苍白球射频毁损术治疗PD的治疗机制。展开更多
Background: Mood, cognitive, and behavioural changes have been reported with deep brain stimulation (DBS) in the thalamus, globus pallidus interna, and anterior limb of the internal capsule/nucleus accumbens region. O...Background: Mood, cognitive, and behavioural changes have been reported with deep brain stimulation (DBS) in the thalamus, globus pallidus interna, and anterior limb of the internal capsule/nucleus accumbens region. Objective: To investigate panic and fear resulting from DBS. Methods: Intraoperative DBS in the region of the right and then left anterior limb of the internal capsule and nucleus accumbens region was undertaken to treat a 52 year old man with treatment refractory obsessive-compulsive disorder (OCD). Mood, anxiety, OCD, alertness, heart rate, and subjective feelings were recorded during intraoperative test stimulation and at follow up programming sessions. Results: DBS at the distal (0) contact (cathode 0-, anode 2+, pulse width 210 ms, rate 135 Hz, at 6 volts) elicited a panic attack (only seen at the (0) contact). The patient felt flushed, hot, fear ful, and described himself as having a “panic attack." His heart rate increased from 53 to 111. The effect (present with either device) was witnessed immediate ly after turning the device on, and abruptly ceased in the off condition. Conclu sions: DBS of the anterior limb of the internal capsule and nucleus accumbens re gion caused severe “panic." This response may result from activation of limbic and autonomic networks.展开更多
文摘目的:应用直流电核团毁损术毁损帕金森病(PD)大鼠模型的内侧苍白球(GPi),记录其手术前后脑电生理活动的变化,以探讨内苍白球射频毁损术治疗PD的可能机制。方法:成年SD大鼠随机分为GP毁损组、假手术组及正常组。对PD毁损组和假手术组大鼠采用6-羟基多巴胺(6-OHDA)右侧黑质致密部(SNc)、中脑腹侧被盖区(VTA)两点注射法建立PD大鼠模型,并经腹腔注射阿扑吗啡(APO)诱发旋转以对模型建立进行评价。通过多导联宏电极在体脑电生理记录技术对各组大鼠进行右侧(注射侧)大脑皮层M1、M2区脑电及纹状体场电位的连续24小时记录,同时进行视频录像。对GP毁损组大鼠行直流电GPi毁损术,术后4天对各组大鼠均行阿扑吗啡诱导旋转行为检验,继续记录脑电活动,记录数据经频率谱分析及相干分析以揭示各记录位点信号的频率成分以及不同位点神经元集群间的功能连接和同步性。结果:对GP毁损组大鼠毁损术前后在清醒静息状态下的皮层脑电和纹状体场电位有明显改变,术后HVSs(High Voltage Spindles)在持续时间上明显缩短发作次数明显减少;对各组大鼠术后在静息状态下的脑电信号进行对比,GP毁损组大鼠较假手术组的HVSs持续时间和发作频率均减少并接近正常组大鼠水平,相干性分析显示GP毁损组大鼠术后在HVSs频段(5-13Hz)上的相干程度显著小于假手术组。结论:在清醒静息状态下6-OHDA建立的PD大鼠皮层-基底节环路上HVSs持续时间延长发生频率增高,经GP毁损术后其时间缩短发作次数减少同步性降低并接近正常水平,从而改善PD症状,该现象可能解释临床采用苍白球射频毁损术治疗PD的治疗机制。
文摘Background: Mood, cognitive, and behavioural changes have been reported with deep brain stimulation (DBS) in the thalamus, globus pallidus interna, and anterior limb of the internal capsule/nucleus accumbens region. Objective: To investigate panic and fear resulting from DBS. Methods: Intraoperative DBS in the region of the right and then left anterior limb of the internal capsule and nucleus accumbens region was undertaken to treat a 52 year old man with treatment refractory obsessive-compulsive disorder (OCD). Mood, anxiety, OCD, alertness, heart rate, and subjective feelings were recorded during intraoperative test stimulation and at follow up programming sessions. Results: DBS at the distal (0) contact (cathode 0-, anode 2+, pulse width 210 ms, rate 135 Hz, at 6 volts) elicited a panic attack (only seen at the (0) contact). The patient felt flushed, hot, fear ful, and described himself as having a “panic attack." His heart rate increased from 53 to 111. The effect (present with either device) was witnessed immediate ly after turning the device on, and abruptly ceased in the off condition. Conclu sions: DBS of the anterior limb of the internal capsule and nucleus accumbens re gion caused severe “panic." This response may result from activation of limbic and autonomic networks.
