微電極針道制圖在丘腦底核電刺激治療帕金森病手術(shù)中的應(yīng)用

微電極針道制圖在丘腦底核電刺激治療帕金森病手術(shù)中的應(yīng)用

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時(shí)間:2018-07-19

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1、微電極針道制圖在丘腦底核電刺激治療帕金森病手術(shù)中的應(yīng)用作者:王學(xué)廉,高國棟,賀世明,李維新,王舉磊,管定國,陳玲【關(guān)鍵詞】微電極ApplicationofmicroelectrodemappinginsurgeryofdeepbrainstimulationofsubthalamicnucleusinamelioratingthesymptomsofParkinsonsdisease【Abstract】AIM:Toimprovetheprecisionoftargetinginsurgeryofthedeepbrai

2、nstimulationofsubthalamicnucleustoamelioratethesymptomsofParkinsonsdiseasebyrecordingneurophysiologicalcharacteristicsofencounteredcellsalongmicroelectrodetrajectoriesandmappingmotorandnonmotorterritoryofSTNusingmicroelectroderecordingtechniques.METHODS:FromNov

3、ember1999toApril2017,30patientswithParkinsonsdiseaseunderwentthesurgeryofdeepbrainstimulationand45electrodeswereimplantedintotheSTN.IndirectedspiralCTscan12/12imagingbasedanatomictargetingwasused.Microelectroderecordingmappingtechniqueswereemployedandthecellula

4、ractivitywasanalyzedforvariousneurophysiologcalparameters,includingfiringpatterns,firingrate,interspikeintervals,backgroundnoise,evokedpotentialandreactionstomicrostimulation.ImagingsofCT/MRIpreoperativeandSchaltenbrandandWahrenatlaswereoverlapped,soastoidentif

5、ythemotorandnonmotorterritoryofSTNandlineouttheboundarywithadjacentnucleus.Thus,thefunctionaltargetingofSTNandtheoptimalplaceofelectrodeimplantwerepreciselylocated.RESULTS:Onehundredandthirtyonemicroelectroderecordingtrajectoriesandmappingswereaccomplished.Thea

6、veragemicroelectroderecordingtimeforeachtrajectorywas20min,withameanof291trajectories/electrode.RecordingsfromtheSTNexhibitedanincreaseinthebackgroundactivityandanirregularfiringpattern,withameanrateofHz.Themeancelldensitywascells/mm,withanaveragelengthfromuppe

7、rboundertolower12/12bounderofmm.ThemovementrelatedcellswerelocatedprimarilyinthedorsolateralsectoroftheSTN,withthelegarealocatedmedialalongthemediolateralaxisandcentrallyalongtheanteroposterioraxis,comparedwiththearmarea.Tremorsynchronizedcellscanalsoberecorded

8、andidentified.Thetargetchangeratewas89%.CONCLUSION:ApplicationofmicroelectroderecordingmappingtechniquescanpreciselylocatethemotorandnonmotorterritoryofSTNandlineoutthebound

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