帕金森病患者苍白球神经元放电特性与症状的关系  

Relation between characteristics of pallidum neuron discharge and the main symptoms in patients with Parkinson disease

作　　者：赵亚群[1] 周敬安[1] 张辉[2] 

机构地区：[1]解放军总医院第二附属医院神经外科,北京市100091 [2]西安交通大学生物医学研究所,陕西省西安市710046

出　　处：《中国临床康复》2006年第2期111-113,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:分析帕金森病患者苍白球神经元放电特性和与主要症状之间的关系。方法:选择解放军总医院第二附属医院神经外科2001-09/2004-01收治的资料齐全的原发性帕金森病患者30例。所有患者进行苍白球毁损术,术前进行统一帕金森病评定量表测评,对各症状进行分项计分;术中连续记录苍白球神经元的放电信号;术后进行付立叶变换,计算最高峰值频率、95%截断频率;以数据有效值为指标研究神经元放电的信号强度。计算神经元放电信号频谱和强度与各症状之间的相关性。结果:30例患者全部进入结果分析。①共采集神经元放电764个,其中单细胞神经元放电共343个,外侧苍白球神经元163个,内侧苍白球神经元180个。②神经元放电的频率:外侧苍白球低于内侧苍白球[(59.50±25.80),(96.87±43.05)Hz,P<0.01]。③内侧苍白球神经元放电的最高峰值频率、95%截断频率和数据有效值均高于外侧苍白球(P<0.05)。④外侧苍白球神经元放电的最高峰值频率、95%截断频率和数据有效值与强直、运动迟缓的分项计分明显相关(简单相关,P<0.05),而与震颤不相关。⑤内侧苍白球神经元放电的最高峰值频率、95%截断频率和数据有效值分别与运动迟缓、震颤、强直的分项计分相关(简单相关,P<0.05)。结论:外侧苍白球的功能异常与强直、运动迟缓有关,内侧苍白球与运动迟缓、震颤和强直都有关系。提示行内侧苍白球毁损术时,毁损区同时累计外侧苍白球时对僵直和运动迟缓可能有较好疗效,治疗震颤的最适手术靶点可能位于内侧苍白球。AIM： To analyze the correlation between the characteristics ofpallidum neuron discharge and the main symptoms in patients with Parkinson disease. METHODS： Thirty patients with Parkinson disease, who had complete data, were selected from the Department of Neurosurgery, Second Affiliated Hospital, General Hospital of Chinese PLA from September 2001 to January 2004. They all received pallidotomy, and they were all measured with uniform Parkinson disease rating scale preoperatively, each symptom was scored. The discharge signals of pallidum neurons were recorded and stored continuously during the operation. Fourier transform was conducted postoperatively, the high-peak-frequency and 95% cutoff-frequency were calculated. Effective value was also computed to express signal intensity. The relations of the spectrum and intensity of neuron discharge signal with the symptoms were calculated. RESULTS： All the 30 patients entered the analysis of results. ①Totally 764 neuron discharges were tested, including 343 were single-unit discharge, 163 neuron discharges located in globus pallidus lateralis （Gpe）, 180 neuron discharges located in globus pallidus medialis （Gpi）. ② Frequency of neuron discharge： The frequency of Gpe neuron discharge was lower than that of Gpi neuron discharge [（59.50±25.80）, （96.87±43.05） Hz, P 〈 0.01]. ③ The high-peak-frequency, 95% cutoff-frequency and effective value of Gpe neuron discharge were all higher than those of Gpi neuron discharge （related simple test, P 〈 0.05）.④ The high-peak-frequency, 95% cutoff-frequency and effective value were in correlation with the scores of rigidity and bradykinesia, but had pallidus lateralis （related simple test, no relation with tremor in globus P 〈 0.05）. ⑤ However the high- peak-frequency, 95% cutoff-frequency and effective value were in relation not only with rigidity, bradykinesia, but also with tremor in globus pallidus medialis （related simple test, P 〈 0.05）. CONCLUSION： Disfunction of globus pal

关 键 词：帕金森病/外科学 帕金森病/康复 苍白球 

分 类 号：R742.5[医药卫生—神经病学与精神病学]