摘要
目的 研究帕金森病患者丘脑腹中间核 (Vim)的电生理特性 ,寻找应用微电极来确定丘脑腹中间作为核毁损术靶点的方法。方法 在对 2 3例震颤型帕金森病患者进行的微电极引导选择性丘脑腹中间核毁损术中 ,比较Vim与其周围结构背景放电、放电幅度和放电频率的差异 ,比较运动觉神经元和震颤细胞对微刺激的反应。结果 腹中间核与腹外侧核、腹后核和内囊的背景放电和放电幅度不同 ,根据神经元在主动和(或 )被动活动对侧肢体时放电是否变化 ,将震颤细胞分为两类 ,两类震颤细胞的分布及微刺激时引起对侧肢体震颤的变化情况存在明显差异。运动觉神经元和震颤细胞在微刺激时引起对侧肢体震颤的变化情况也存在明显差异。结论 微记录能确定Vim前界 ,联合应用微刺激和微记录才能迅速、准确的确定Vim后界及手术靶点内外侧界。毁损靶区应包括在主动和 (或 )
Objective To investigate the electrophysiological characteristics of the ventralis intermedius nucleus (Vim) in order to find an easy and safe way to confirm the target in Vim-thalamotomy. Method In microelectrode-guided selective Vim-thalamotomy for 23 Parkinson's disease patients, the background activity, amplitude and discharge frequencies of Vim were compared with its surrounding structures. The response of kinesthetic neuron and tremor cell to microstimulation was also compared. Result There were differences in backgroud activity and discharge amplitude for Vim, ventralis lateralis nucleus (VL), ventralis caudalis nucleus (VC), and internal capsule. Based on the response to active or passive movement of contralateral limb tremor cells were divided into two subgroups, which were different in localization. Contralateral tremor showed different response when the two subgroups of tremor cells were mircrostimulated. Conclusion The anterior border of Vim was easily found by microrecording. Only by combining microstimulation with microrecording could the posterior border of Vim and its interior and lateral ordination of target were identified exactly and safely. Kinesthetic neurons and tremor cells which responded to the movement of contralateral limbs should be destroyed.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2004年第5期421-423,共3页
Medical Journal of Chinese People's Liberation Army
关键词
帕金森病
震颤
丘脑腹中间核
立体定向手术
Parkinson's disease
tremor
ventralis intermedius nucleus
stereotaxy
