颅内电极皮层电刺激皮层后放电的抑制规律研究  

The inhibition of after-discharges caused by electrical cortical stimulation

作　　者：任志伟[1] 遇涛[1] 张国君[1] 杜薇[1] 徐翠萍[1] 朴媛媛[1] 周晓霞[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：《癫痫与神经电生理学杂志》2016年第6期321-325,329,共6页Journal of Epileptology and Electroneurophysiology(China)

基　　金：国家自然科学基金面上项目（编号：81471328）

摘　　要：目的：通过对后放电（AD）进行脉冲刺激抑制的研究，为皮层电刺激（ECS）治疗癫癎摸索合理的刺激参数。方法：回顾性研究2011～2012年行癫癎颅内电极埋置术并接受ECS病人的脑电图（EEG）资料共10例，如患者反复出现AD，即在相同位置给予相同参数的短暂脉冲刺激（BPS），有时可终止AD，对皮层AD的抑制规律进行分析。结果：对64个点重复刺激后可重复出现AD触点45个（70％），对这45个AD点给予BPS，其中13个（29％）在刺激后2s内AD终止，对比不同的AD波形、频率、部位、时相、累及范围、是否远隔、刺激潜伏期与BPS干预效果相关。结论：当在AD波形的负相峰及下降期，AD波形表现为棘慢波及节律性波，BPS潜伏期越短时，BPS干预AD更加有效。Objective： To explore the reasonable stimulation parameters for cortical stimulation treatment of epilepsy through brief pulse stimulation to suppress after-discharges（AD）. Methods：A retrospective analysis of EEG data was made from 10 patients with epilepsy who underwent intracranial electrodes surgery and electronic cortical stimulation （ECS）. When AD recurred, brief pulse stimulations （BPS） were preformed at the same location and the same parameter, and AD could be inhibited sometimes. Research was made on the difference of inhibiting effects, the characteristics of AD and the application timing of BPS. Results：As repeated ECS were taken at 64 points,45 of AD could be stirred up,then while BPS was employed BPS, 13 points could be terminated within 2 seconds. Conclusion.. When AD waveforms of the negative peak and decrement phase, AD show spike-waves and rhythmic waves. The shorter the latency is,the more effective BPS termination of AD.

关 键 词：癫癎 皮层电刺激(ECS) 皮层功能定位 后放电(AD) 致癎灶 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]