异丙酚降低帕金森病患者丘脑下核神经元放电活动  

作　　者：Aeyal Raz, MD, PhD Dan Eimerl, MD Adam Zaidel, MSc Hagai Bergman, MD, PhD Zvi Israel, MD 吴德华(译) 曹晖(校) 徐美英(校) 

机构地区：[1]Rabin Medical Center, Beilison Hospital, Petah Tikva: [2]Hadassah Hebrew University Medical Center, Jerusalem [3]Hebrew University, Hadassah Medical School, Jerusalem, Israel [4]不详

出　　处：《麻醉与镇痛》2012年第3期76-80,共5页Anesthesia & Analgesia

摘　　要：背景治疗帕金森病患者时，通常采用微电极记录仪（microelectrode recording，MER）记录丘脑下核（subthalamic nucleus，STN）神经元峰电位活动来指导实施在STN植入深部脑刺激（deep brain stimulation，DBS）电极。镇静药物对丘脑下核的微电极记录干扰程度如何目前仍不清楚。本研究监测了异丙酚镇静期间丘脑下核神经元放电活动，及对神经元电活动的影响。方法选择需要进行深部脑电刺激手术的帕金森病患者，固定电极定位于丘脑下核部位，给患者静脉输注异丙酚50μg·kg^-1·mm^-1，直到患者处于稳定镇静期。记录神经元电活动，计算异丙酚输注前、中、后神经元电活动的均方根（root mean square，RMS）。结果16例患者中记录了24次电极轨迹的活动，异丙酚注射后其中18次出现明显的丘脑下核电活动的均方根降低。异丙酚输注期间，平均均方根降低23．2％±9．1％（均数±标准差）（P〈0．001），停止输注后回到基线时间为（9．3±4．0）分钟。结论异丙酚输注导致丘脑下核神经峰电活动显著降低，说明它可能干扰丘脑下核边缘微电极记录电活动的识别。停止异丙酚输注后，神经元电活动很快恢复到基线，因此，异丙酚在微电极记录仪指导DBS前可安全地使用。BACKGROUND： Implantation of deep brain stimulation （DBS） electrodes in the subthalamic nucleus （STN） for the treatment of Parkinson disease is often performed using microelectrode recording （MER） of STN population spike activity. The extent to which sedative drugs interfere with MER is unknown. We recorded the population activity of STN neurons during propofol sedation and examined its effect on neuronal activity. METHODS： The procedure was performed during DBS surgery for Parkinson disease. We administered propofol （50 μg/kg/min） at a constant electrode location in the STN until stable sedation was achieved. We recorded the electrical activity, and calculated its root mean square （RMS） before, during, and after the propofol infusions. RESULTS： The activity of 24 electrode trajectories was recorded in 16 patients. The RMS of STN activity decreased significandy after propofol administration in 18 of the 24 trajectories. The average normalized RMS decreased by 23.2% ± 9. 1% （mean ± SD） during propofol administration （P 〈 0. 001）, and returned to baseline 9.3 ± 4.0 minutes after it was stopped. CONCLUSIONS： Propofol administration leads to a significant decrease of STN neuronal activity. Thus, it may interfere with MER identification of the STN borders. However, activity returns to baseline shortly after administration stops. Therefore, propofol can be safely used until shortly before MER for DBS.

关 键 词：神经元放电活动 异丙酚镇静 帕金森病 丘脑 患者 神经元电活动 微电极记录 静脉输注 

分 类 号：R971.4[医药卫生—药品]