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

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1、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ApplicationofmicroelectrodemappinginsurgeryofdeepbrainstimulationofsubthalamicnucleusinamelioratingthesymptomsofParkinsonsdisease【Abstract】AIM:Toimprovetheprecisionoftargetinginsurgeryofthedeepbrai

2、nstimulationofsubthalamicnucleustoamelioratethesymptomsofParkinsonsdiseasebyrecordingneurophysiologicalcharacteristicsofencounteredcellsalongmicroelectrodetrajectoriesandmappingmotorandnonmotorterritoryofSTNusingmicroelectroderecordingtechniques.METHODS:FromNov

3、ember1999toApril2017,30patientswithParkinsonsdiseaseunderwentthesurgeryofdeepbrainstimulationand45electrodeswereimplantedintotheSTN.IndirectedspiralCTscan12/12imagingbasedanatomictargetingwasused.Microelectroderecordingmappingtechniqueswereemployedandthecellula

4、ractivitywasanalyzedforvariousneurophysiologcalparameters,includingfiringpatterns,firingrate,interspikeintervals,backgroundnoise,evokedpotentialandreactionstomicrostimulation.ImagingsofCT/MRIpreoperativeandSchaltenbrandandWahrenatlaswereoverlapped,soastoidentif

5、ythemotorandnonmotorterritoryofSTNandlineouttheboundarywithadjacentnucleus.Thus,thefunctionaltargetingofSTNandtheoptimalplaceofelectrodeimplantwerepreciselylocated.RESULTS:Onehundredandthirtyonemicroelectroderecordingtrajectoriesandmappingswereaccomplished.Thea

6、veragemicroelectroderecordingtimeforeachtrajectorywas20min,withameanof291trajectories/electrode.RecordingsfromtheSTNexhibitedanincreaseinthebackgroundactivityandanirregularfiringpattern,withameanrateofHz.Themeancelldensitywascells/mm,withanaveragelengthfromuppe

7、rboundertolower12/12bounderofmm.ThemovementrelatedcellswerelocatedprimarilyinthedorsolateralsectoroftheSTN,withthelegarealocatedmedialalongthemediolateralaxisandcentrallyalongtheanteroposterioraxis,comparedwiththearmarea.Tremorsynchronizedcellscanalsoberecorded

8、andidentified.Thetargetchangeratewas89%.CONCLUSION:ApplicationofmicroelectroderecordingmappingtechniquescanpreciselylocatethemotorandnonmotorterritoryofSTNandlineoutthebound