微电极记录与影像技术联合应用对帕金森病脑深部电刺激最佳刺激治疗位置的研究

目的探讨帕金森病(PD)患者脑深部电刺激(DBS)术最佳刺激靶点的位置。方法 40例PD患者接受立体定向双侧丘脑底核(STN)脑深部电刺激术。术中通过微电极记录采集神经元电活动,埋置脑深部电刺激器,术后复查电极位置,通过影像资料和电生理数据,确定电极尖端坐标,并计算电极各触点坐标,以及电极针道中STN上下边界和中心点的坐标。结果最佳刺激触点中心坐标的平均位置与STN上边界坐标的平均位置的差异无统计学意义。结论 STN上边界区域为DBS治疗PD的最佳刺激位置。

Optimal target localization for subthalamic stimulation in patients with Parkinson disease by MRI confirmation and microelectrode recordings

Objective To further determine the efficient contact area from deep brain stimulation ( DBS ) of the subthalamic nucleus ( STN ) in patients with Parkinson disease ( PD ) . Methods 40 patients with PD underwent the implantation of electrodes into the STN . Microelectrode recordings were performed in the STN during surgery and neuronal activity was analyzed offline .The distance between the target and the electrode was calculated individually in each axis MRI .Results Most of the space defined by the active contacts distribution was inside that defined by the STN-dorsal border distribution . Conclusion This approach proposed for the localization of the electrodes on MRI shows that DBS is most effective in the dorsal part of the STN .