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目的探讨丘脑底核(STN)细胞电活动、脑深部刺激(DBS)电极触点位置与帕金森病(PD)症状改善的关系。方法19例 PD 患者在接受 STN DBS 治疗的同时采集细胞电活动和肢体EMG。应用单细胞分析、相关性检验探讨不同放电模式细胞活动与症状的关系,PD 综合量表进行术前和术后疗效评估。结果在278个 STN 神经元中发现与震颤相关(12.6%)的放电活动多分布在STN 上部,而紧张性(32.7%)和不规则(54.7%)放电活动多分布在 STN 下部,进一步比较 STN 上下部各类细胞的分布均有统计学意义(P<0.05)。对 DBS 刺激触点的疗效分析发现,上部触点对震颤改善显著,而下部触点对僵直和迟缓的改善明显。结论 STN 不同放电模式神经元与 PD 症状有内在联系。
Objective To investigate the relationship between the electrical activity of subthalamic nucleus (STN) cells and the contact location of deep brain stimulation (DBS) electrodes and the improvement of symptoms of Parkinson’s disease (PD). Methods Twenty-nine patients with PD underwent STN-treated DBS while collecting EMG. Single cell analysis and correlation test were used to investigate the relationship between cell activity and symptoms in different discharge modes. The PD comprehensive efficacy scale was evaluated preoperatively and postoperatively. Results 277 STN neurons were found to be associated with tremor (12.6%) in the discharge activity distribution in the upper STN, while tension (32.7%) and irregular (54.7%) discharge activity distribution in the STN lower further comparison of STN The distribution of various types of cells in the upper and lower sides were statistically significant (P <0.05). Efficacy analysis of the DBS stimulated contacts revealed that the upper contacts significantly improved tremor while the lower contacts showed a significant improvement in stiffness and retardation. Conclusion STN neurons in different discharge modes are intrinsically linked with PD symptoms.