皮层电刺激定位功能区的有效刺激参数研究

A study on effective parameters of electric cortical stimulation for motor - sensory brain mapping

目的 探讨手术治疗中央区癫痫时,皮层电刺激功能区定位的有效刺激参数.方法 回顾性分析2006年10月至2008年3月北京功能神经外科研究所连续收治的21例中央区癫痫患者的临床资料,研究皮层电刺激功能定位时,感觉、运动及后放电阈值之间的差异以及与阈值相关的因素.结果 运动、感觉、后放电的平均阈值分别为：（3.48±0.87）mA、（3.86±1.31）mA和（4.84±1.38）mA.后放电阈值高于运动、感觉阈值（P＜0.05）,且与病史呈负线性关系.结论 以频率50 Hz、脉宽0.2 ms、刺激强度8 mA以下等刺激参数行皮层电刺激定位功能区是安全可靠的;皮层功能定位应个体化实施.

Objective The purpose of the study was to investigate the effective parameters of electric cortex stimulation （ECS）for functional brain mapping.Method We collected 21 subjects who underwent epilepsy surgeries consecutively in Beijing Institute of Functional Neurosurgery with the epileptogenic zone located in perirolandic areas from October 2006 to March 2008.With retrospective study, we systematically analyzed the information about threshold of motor and sensory response and afterdischarge.Results The average threshold of motor and sensory response and afterdischarge were （3.48 ± 0.87 ） mA, （ 3.86 ± 1.31 ）mA, （4.84 ± 1.38） mA respectively.The average threshold of afterdischarge was higher than that of motor and sensory response.The difference was significant （ P ＜ 0.05 ）.The threshold of afterdischarge was in negative linear correlation with illness duration.Conclusions The ECS parameters of 50 Hz, 0.2 ms for functional brain mapping are effective and safety; ECS should be performed respectively.