内苍白球震颤细胞的电活动与帕金森性震颤  

Tremor-related neuronal activity in globus pallidus internus in parkinsonian patients

作　　者：李勇杰[1] 庄平[1] 赵国光 石长青 张宇清 李建宁 

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,100053

出　　处：《中华神经外科杂志》2002年第1期18-21,共4页Chinese Journal of Neurosurgery

基　　金：国家科委和北京科委基金资助 (项目编号 95 330 40 0 1)

摘　　要：目的　探讨帕金森病 (PD)特征性震颤与内苍白球 (GPi)神经元电活动的关系 ,指导手术靶点的精确定位。方法　 10例PD患者接受了立体定向苍白球腹后部毁损术 ,术中应用微电极和肌电 (EMG)记录技术 ,采集GPi神经元和肢体震颤的生物电活动。术后应用分析软件甄别单细胞及其电活动特点 ,分析其与震颤症状的关系 ,并进行相关性检验。结果　在GPi共记录到了 112个神经元 ,有 5 7个 (5 1% )震颤细胞 ,且主要分布在视束上方 4～ 6mm ,其簇状放电的节律与肢体震颤的节律高度一致 (4～ 6Hz) ,R2 =0 71(P <0 0 1)。毁损震颤细胞导致震颤症状的消失。结论　震颤型PD患者的GPi存在电活动与肢体震颤节律一致的震颤细胞。该细胞的发现和定位 ,对于指导手术毁损的部位和范围具有重要意义。Objective To investigate the correlation between parkinsonian tremor and neuronal activity in globus pallidus internus (GPi) for precise target localization during posteroventral pallidotomy (PVP). Methods Ten cases of idiopathic parkinsonian patients who all had symptom of rest tremor were received microelectrode-guided PVP. Spontaneous neuronal activities in Gpi were recorded intraoperatively. The electromyograms(EMG) were also recorded simultaneously on the contralateral limbs of the surgery. Single unit analysis was carried out. Cross correlation was performed to study GPi cell firing in relation to limb tremor. Results 112 GPi cells were discriminated in 10 trajectory recordings. 57(51%) cells presented burst firing at a frequency range 4～6Hz and recognized as the same rhythmic frequency with parkinsonian tremor measured by EMG. The individual values were highly correlated (R 2=0.71,P<0.01). Those tremor-related cells mostly located 4～6mm above the optic tract were destroyed during the surgery, and as a result tremor disappeared. Conclusions Tremor-related cells exist in GPi, especially in the posteroventral part. To recognize and localize those cells with microrecording technique during surgery is critical for lesioning site and size determinations.

关 键 词：帕金森病 震颤 苍白球毁损术 震颤细胞 立体定向 

分 类 号：R742.5[医药卫生—神经病学与精神病学]