帕金森病患者丘脑腹外侧核团神经元振荡活动特点  

Oscillatory activity in ventrolateral thalamus of patients with Parkinson＇s disease

作　　者：何柳[1] 庄平[1] 张宇清[1] 李建宇[1] 李勇杰[1] 

机构地区：[1]首都医科大学宣武医院,北京功能神经外科研究所,教育部神经变性病学重点实验室,北京100053

出　　处：《中华神经外科杂志》2013年第4期362-366,共5页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金资助（30370473,30770746,81171061）

摘　　要：目的探讨帕金森病（PD）患者丘脑腹外侧核团（Vop／Vim）神经元振荡活动与PD症状的关系。方法23例PD患者在接受立体定向丘脑毁损术时应用微电极和肌电记录技术采集细胞和肢体电活动。单细胞和峰间隔分析鉴别细胞放电频率和模式；功率谱分析神经元振荡活动与症状的关系。PD综合评分量表（UPDRS）进行疗效评估。结果114个振荡活动神经元中78％伴有震颤节律，并与肢体震颤相关；22％伴有B节律。发现震颤节律振荡活动神经元主要分布在Vim，β节律振荡活动神经元主要分布在Vop（P〈0．05）。结论Vim是改善震颤的最佳靶点。B节律振荡活动神经元与僵直、运动不相关，提示Vop可以改善PD僵直和迟缓。Objective To explore the neuronal oscillatory activity in the ventrolateral thalamus （the ventral oral posterior nucleus, Vop/the ventral intermediate nucleus, Vim） in relation to parkinsonian motor signs. Methods 23 patients （ M ： 20, F ： 3 ; mean age ： 60. 6 ± 8.2 years, mean duration of disease ： 6. 6 ± 3.4 years） with Parkinson＇s disease （PD） who underwent thalamotomy were studied. Their mean Hoehn ＆ Yahr score was 2. 2 ± 0. 4, and the unified Parkinson＇s disease rating scale （UPDRS III）during＂ OFF＂ state was 42.4 ± 12. 1. The average L - dopa daily dose was 551.7 ± 219. 5 rag. Microelectrode records in Vop/Vim and electromyography （EMG） on contralateral limbs to surgery were simultaneously performed. Single unit analysis, interspike interval （ISI） was used to study neuronal firing rate and pattern. Power spectral analysis was carried out to evaluate neuronal oscillation. Coherence analysis was used to study neuronal activity in relation to limb EMG. Clinical outcome was calculated by （presurgery - postsurgery/presurgery） x 100. Results 190 neurons were identified. Power spectral analysis showed that 60% （ n = 114） neurons had oscillatory activity. Of those oscillatory neurons, 78% （ n =89） neurons had tremor frequency band （ 3.0 ± 7.5 Hz ） （ TFB ） . Oscillation showing as same frequency as tremor （ P 〈 0. 05 ） ; 22% （ n = 25 ） neurons had β frequency band （ 8 - 30 Hz） （ [3FB ） oscillation. Further analysis showed that majority of neurons with TFB oscillation localized in Vim, while majority of neurons with βFB oscillations localized in Vop （ t = 2. 048, P 〈 0. 05）. In addition, it was found that the mean firing rate of oscillatory neurons in Vop was significantly lower than those neurons in Vim （24. 3 ±9. 9 Hz vs 28.5 ± 12.4 Hz, t = 1. 988, P 〈 0. 05 ）. UPDRS revealed that clinical improvement was 89. 7% for tremor,48.4% for rigidity and 38. 1% for bradykinesia respectively. Conclusions The data support that

关 键 词：帕金森病 丘脑腹侧核 微电极 神经元 振荡 

分 类 号：R742.5[医药卫生—神经病学与精神病学]