帕金森病丘脑底核β振荡活动与自主运动的相关性  

β oscillatory activity of subthalamic nucleus is associated with voluntary movement in Parkinson＇s disease

作　　者：崔青山[1] 庄平[1] 王云鹏[1] 张宇清[1] 李建宇[1] 胡永生[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,北京100053

出　　处：《中华神经外科杂志》2016年第5期480-485,共6页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金（81171061,81371256,81361128012）

摘　　要：目的探讨帕金森病丘脑底核（STN）β频谱振荡活动神经元是否与自主运动相关，为临床治疗提供依据。方法回顾性分析首都医科大学宣武医院功能神经外科2014年4月至2015年8月收治的17例行STN脑深部电刺激术治疗的帕金森病患者。术中应用微电极和肌电记录技术同时采集STN细胞电活动和手术对侧肢体肌电，要求患者执行10s间隔的腕伸运动。依据运动过程，将运动界定为基线、运动前、运动和运动后4个阶段。单细胞分析探讨神经元放电频率（MFR）、峰间隔变异系数（CV）。功率谱分析探讨STN振荡活动神经元的特点。方差分析和Bonfferoni检验探讨不同运动阶段MFR与CV的变化。结果在119个神经元中，38．7％（46／119）伴有β频谱振荡活动，其频谱为13～30Hz（21．0±5．1）Hz。在这46个神经元中，43．5％（20／46）与运动相关，26．1％（12／46）表现为与运动相关去同步化，17．4％（8／46）表现为与运动相关的同步化；运动时放电频率的变化与基线相比差异均有统计学意义（均P〈0．05）。另外，与运动相关的神经元主要分布在STN中上部。结论STN存在与运动相关的β振荡活动神经元，放电频率的变化可能参与自主运动。与运动相关的神经元主要分布在STN背旁侧感觉运动区域，为脑深部电刺激术治疗帕金森病最佳触点的选择提供依据。Objective To investigate whether β oscillatory neuron of subthalamic nucleus （STN） is associated with voluntary movement in Parkinson ＇s disease （PD） and to provide the basis for clinical treatment. Methods Seventeen patients with PD treated with STN deep brain stimulation （DBS） at the Department of Neurosurgery, Beijing Xuanwu Hospital, Capital Medical University from April 2014 to August 2015 were analyzed retrospectively. The STN cell electrical activities and limb electromyograms on the opposite sides of surgery were collected at the same time using microelectrode and EMG recording techniques during the procedure. The patients were asked to perform 10 s interval of wrist extension movement. The movement was divided into 4 stages according to the movement process ： the baseline, before the movement, movement, and after the movement. Single-unit analysis was used to investigate the mean firing rate （MFR） of neurons and the coefficient of variation （CV） of inter-spike intervals. Power spectral analysis was used to investigate the STN oscillatory neuron characteristics. Variance analysis and Bonfferoni test were used to investigate the changes of MFR and CV in different movement stages. Results In 119 neurons, 38.7% （46/119） were accompanied by β oscillatory activity; their spectrums were 13-30 Hz （21.0 ±5.1 Hz）. In the 46 neurons, 43.5% （20/46） were associated with movement, 26.1% （12/46） showed the desynchronization associated with movement, and 17.4% （8/46） showed the synchronization associated with movement. There were significant differences in the changes of discharge frequency during the movement compared with the baseline （ all P 〈 0.05 ）. In addition, the movement-related neurons were mainly distributed in the middle-upper part of STN. Conclusions STN has β oscillatory neurons associated with movement. The changes of discharge frequency may participate in voluntary movement. The neurons associated with movement mainly distribute in dorsal flanking sen

关 键 词：帕金森病 丘脑底核 β振荡活动神经元 自主腕伸运动 微电极记录 

分 类 号：R742.5[医药卫生—神经病学与精神病学]