帕金森病患者丘脑腹外侧核的微电极定位技术

Microrecording techniques for targeting of ventrolateral thalamus in patients with Parkinson's disease

目的研究帕金森病患者丘脑腹外侧核(VL)神经元电活动的特点,指导手术靶点的精确定位。方法25例患者在接受立体定向丘脑手术时,应用微电极记录技术采集细胞的电活动资料,分析单细胞的电活动。结果共记录并甄别出258个神经元,44%的神经元簇状放电的节律与肢体震颤的节律高度相关(R=0.78),确认为震颤细胞,且多数位于Vim(n=75);11%的神经元放电对肢体运动有反应,确认为运动相关细胞。结论VL中的细胞电活动有明确的特点,特别是Vim存在着大量的震颤细胞,为手术靶点的定位提供了重要指征。

Objective To investigate the characteristics of neuronal activity for precisely targeting ventrolateral thalamus(VL) in patients with Parkinson's disease (PD). Methods Microrecording was performed during stereotactic thalamic surgery in 25 PD patients. Neuronal activity in VL and contralateral limbic electromyogram (EMG)were recorded simultaneously. The technique of single unit analysis was employed. Results A group of 258 VL neurons were identified in 25 recording trajectories. Of which, 44% of neurons (n=113)were identified as tremor synchronous cells (tremor cells)(R2=0.78). Most of tremor cells (n=75) were localized inside of Vim, especially close to the Vc. The neurons responded to active or passive movements were found in 11% (n=28) as movement-related cells. The rest of neurons (45%) firing either in a tonic pattern or an irregular bursting in VL could not be classified. Neuronal activity in Vc demonstrated low-noise level, low-frequency firing, and tactile-response. Conclusion There are significant characteristics of neuronal activity along microrecording trajectory in VL, especially a number of tremor cells existing in Vim. Those can be applied for functional localization of VL during stereotactic surgery, either thalamotomy or deep brain stimulation.