帕金森病患者丘脑底核高频电刺激对脑电活动的影响  

The effect of high frequency electrical stimulation of subthalamic nucleus on brain electrical activity in patients with Parkinson’s disease

作　　者：刘海霞[1] 刘清海[1] 刘扬[1] 王天龙[1] Liu Haixia;Liu Qinghai;Liu Yang;Wang Tianlong(Department of Anesthesiology and Operating Theater,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院麻醉手术科 国家老年疾病临床研究中心

出　　处：《北京医学》2019年第7期566-569,共4页Beijing Medical Journal

基　　金：北京市医院管理局临床医学发展专项——“扬帆”计划(ZYLX201818)

摘　　要：目的探讨帕金森病患者丘脑底核高频电刺激对大脑脑电活动的影响。方法将拟行丘脑底核脑深部电刺激术的帕金森病患者纳入研究,采用脑电双频指数监测仪(BIS-VISTA)监测脑电双频指数(bispectral index, BIS)、肌电指数(electromyogram index, EMG)以及95%边缘频率(spectral edge frequency, SEF),观察经脑深部电极高频电刺激前(T0)、丘脑底核高频电刺激时(T1)以及停止高频电刺激后60 s(T2)3个时间点的BIS、EMG及SEF的变化。结果共纳入23例患者,排除BIS-VISTA信号质量低于80%的1例患者,共有22例患者的数据纳入分析。高频电刺激后,T1时点的BIS、EMG、SEF均明显增高。BIST1>BIST2>BIST0,3个时间点的差异有统计学意义(P <0.001);95%SEFT1>95%SEFT0>95%SEFT2,3个时间点的差异有统计学意义(P <0.001);EMGT1>EMGT2>EMGT0,3个时间点的差异有统计学意义(P <0.001)。高频电刺激期间,同一时点左右侧的BIS、EMG及95%SEF的差异无统计学意义(P> 0.05)。结论帕金森病患者行丘脑底核高频电刺激可升高BIS、EMG及95%SEF,对大脑脑电活动有兴奋作用。Objective To investigate the effect of high frequency stimulation(HFS) of subthalamic nucleus on brain electrical activity in patients with Parkinson’s disease. Methods Patients with Parkinson’s disease who underwent subthalamic deep brain electrical stimulation were included in the study. Bispectral index(BIS), electromyogram index(EMG) and 95%spectral edge frequency(SEF) were observed in the deep brain electrodes before HFS(T0), during HFS(T1), and 60 s after HFS(T2). Results One patient with bis-vista signal quality lower than 80% was excluded, 22 patients were enrolled in the study. BIS increased during HFS. The difference was statistically significant among three time points(P < 0.001), BIST1>BIST2>BIST0. 95% SEF increased after HFS. The difference was statistically significant among three time points(P < 0.001),95%SEFT1>95% SEFT0>95% SEFT2. EMG increased after HFS. The difference was statistically significant among three time points(P < 0.001), EMGT1>EMGT2>EMGT0. There were no significant differences between the left side of BIS, EMG and 95%SEF and those of the right side at the same time point(P > 0.05). Conclusions In patients with Parkinson’s disease, HFS of the subthalamic nucleus can increase BIS, EMG and 95% SEF,which has an excitatory effect on brain.

关 键 词：帕金森病 高频电刺激 脑电双频指数 肌电指数 边缘频率 

分 类 号：R742.5[医药卫生—神经病学与精神病学]