微电极针道制图在丘脑底核电刺激治疗帕金森病手术中的应用_医学论文.docVIP

微电极针道制图在丘脑底核电刺激治疗帕金森病手术中的应用_医学论文 微电极针道制图在丘脑底核电刺激治疗帕金森病手术中的应用_医学论文 作者：王学廉，高国栋，贺世明，李维新，王举磊，管定国，陈玲 【关键词】 微电极 　　Application of microelectrode mapping in surgery of deep brain stimulation of subthalamic nucleus in ameliorating the symptoms of Parkinsons disease 　　【Abstract】 AIM: To improve the precision of targeting in surgery of the deep brain stimulation of subthalamic nucleus (STN) to ameliorate the symptoms of Parkinsons 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 Parkinsons disease underwent the surgery of deep brain stimulation and 45 electrodes were implanted into the STN. Indirected spiral CT scan imagingbased 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 291 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 (58±14) cells /mm, with an average length from upper bounder to lower bounder of (58±08) mm. The movementrelated cells were located primarily in the dorsolateral sector of the ST