中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (7): 644–648.doi: 10.12007/j.issn.0258-4646.2016.07.015

• 论著 • 上一篇    下一篇

多通道微电极记录引导下精准定位丘脑底核感觉-运动区

王军 1,罗晓光 2,任艳 2,何志义 2,王运杰 1   

  1. 中国医科大学附属第一医院 1 神经外科;2 神经内科,沈阳 110001
  • 收稿日期:2015-12-22 出版日期:2016-07-29 发布日期:2016-06-27
  • 通讯作者: 王运杰 E-mail:wyj024@vip.sina.com
  • 作者简介:王军(1981 -),男,副教授,博士后 .

Multiple Microelectrode Guided Precise Positioning of Sensory-motor Area of the Subthalamic Nucleus

WANG Jun1,LUO Xiaoguang2,REN Yan2,HE Zhiyi2,WANG Yunjie1   

  1. 1 Department of Neurosurgery,The First Hospital,China Medical University,Shenyang 110001,China;2 Department of Neurology,The First Hospital,China Medical University,Shenyang 110001,China
  • Received:2015-12-22 Online:2016-07-29 Published:2016-06-27

摘要: 目的 探讨多通道微电极记录技术在脑深部电刺激术(DBS)中定位丘脑底核(STN)感觉-运动区中的意义。方法 对22 侧多通道微电极记录下 DBS 术中 STN 的电生理学结果进行分析,并与同期 20 侧单通道微电极记录下 STN 的电生理学结果进行比较。结果 多通道微电极记录下 22 侧 DBS 术中共行 64 根微电极记录,其中 21 侧(95.5%)可以确切记录到 STN 的感觉-运动诱发电位,1 侧可以确切记录到 STN 的常规放电,21 侧最佳电生理学针道记录到 STN 放电的平均长度为(5.58±0.53)mm,其中STN 感觉-运动诱发电位的平均长度为(3.27±1.54)mm;而 20 侧单通道微电极记录到 STN 放电的平均长度为(5.02±1.01)mm,其中 13 侧(65.0%)可记录到 STN 的感觉-运动诱发电位,平均长度为(1.36±0.98)mm,7 侧仅可以确切记录到 STN 的常规放电。22侧 STN 多通道微电极记录下 13 侧最终选择靶点与术前的解剖定位一致,吻合率为 59.1%,9 侧 STN 解剖定位靶点与电生理学功能靶点存在差异。结论 DBS 术中多通道微电极记录与单通道微电极记录相比,在记录到的 STN 放电的平均长度、感觉-运动诱发电位平均长度、确认 STN 感觉-运动区概率及选择最佳植入针道等多方面均有明显优势,这对 DBS 术中确保植入电极位置的精准提供了前提。

关键词: 丘脑底核, 帕金森病, 微电极, 电生理记录

Abstract: Objective To explore the significance of multiple microelectrode guided technique in determining the sensory-motor area of the subthalamic nucleus(STN)in deep brain stimulation(DBS)surgeries. Methods A total of 22 electrophysiological recording data of STNs recorded by multiple microelectrode was retrospectively analyzed,while another 20 electrophysiological recording data of STNs recorded by a single microelectrode was recruited as the control group. Results A total of 64 microelectrodes were used in 22 STNs guided by multiple electrophysiological recording electrodes. Sensory or motor activated potentials were recorded in 21 sides(95.5%),while regular discharge was recorded in one side. The average length of typical STN activity on the optimal channel of multiple electrophysiological recording electrodes was 5.58±0.53 mm,and the average length of sensory or motor activated potentials was 3.27±1.54 mm. In contrast,the average length of typical STN activity recorded by single microelectrode was 5.02±1.01 mm. However,sensory or motor activated potentials were recorded in 13 sides(65.0%)with the average length of 1.36±0.98 mm. Among the 22 STNs guided by multiple electrophysiological recording electrodes,the final implanted target was consistent with the initially selected anatomic target in 13 sides(coincidence rate,59.1%). In 9 sides,the electrophysiological target was inconsistent with the initially selected anatomic target. Conclusion STN DBS performed with multiple electrophysiological recording electrodes resulted in better outcomes of recording of the average length of typical STN activity or the average length of sensory or motor activated potentials of STN,final confirmation of STN sensory motor area and determination of the optimal channel of implantation. Application of multiple electrophysiological recording electrodes provides a premise for the precise electrode placement in STN DBS surgeries.

Key words: subthalamic nucleus, Parkinson’s disease, microelectrode, electrophysiological recording

中图分类号: 

  • R742.5
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