临床神经外科杂志2016，Vol.13Issue(6)：401-405,5.DOI:10.3969/j.issn.1672-7770.2016.06.001
多通道微电极记录在帕金森病脑深部电刺激定位中的作用
Role of multichannel microelectrode recording on location of lead implants for deep brain stimulation
摘要
Abstract
Objective Subthalamic nucleus ( STN ) was recognized as a major target for deep brain stimulation ( DBS) for Parkinson ' s disease ( PD) .Multichannel microelectrode recording could accurate identify the sensory-motor area of STN , improve the precision and treatment effect of DBS . However , the reports of the method and risk of multichannel microelectrode recording were rare .In 10 patients with PD, multichannel microelectrode recording were used during STN-DBS surgeries, to explore the role and risk of multichannel microelectrode recording on the accurate location of lead implants for DBS.Methods From Oct, 2012 to May, 2013, in 10 patients with PD, multichannel microelectrode recording ( 4-5 channels ) were used during STN-DBS surgeries .Final lead implanted channel was chosen by synchronous scores and the result of macro electrode stimulation . We compared the differences between the predetermined location and the final location of lead implants, and measure the length of channels .Results Different channel recorded neuronal firing pattern , intensity and length of different neuron discharge .The final implanted channels and predet ermined central targets were compared .During left-STN location , central channel was chosen in 6 sides,while non-central channel in 4 sides, including anterior channel in 2 sides ( 20%);lateral channel in 1 side;medial channel in 1 side.During right-STN location,central channel was chosen in 5 sides,while non-central channel in 5 sides,including lateral channel in 4 side;medial channel in 1 side.The average length of the sensory-motor area of left STN activity was 4.85 ±1(3-6 mm), and the average length of the sensory-motor area of right STN activity was 4.83 ±0.7(4-6 mm).There was on significant bleeding complication during total 10 surgeries .Conclusions Only in 50%~60%patients ,predetermined central targetz were chosen , while in 40%~50%patients ,the final implanted targets were inconsistent with the predetermined target .Multichannel microelectrode recording could cover the whole STN , and by recording and analyzing the electrical signals ,it could accurate identify the sensory-motor area of STN and choose the optimal lead implanted channel , resulting in better outcomes of DBS treatment .Meanwhile,there was no significant bleeding complication .Application of multichannel microelectrode recording provides an effective monitoring method for better precise location and a safe method in DBS surgeries .关键词
多通道微电极记录/丘脑底核/帕金森病/脑深部电刺激Key words
multichannel microelectrode recording/subthalamic nucleus/Parkinson's disease/deep brain stimulation分类
医药卫生引用本文复制引用
徐欣,凌至培,余新光,潘隆盛,崔志强,毛之奇..多通道微电极记录在帕金森病脑深部电刺激定位中的作用[J].临床神经外科杂志,2016,13(6):401-405,5.基金项目
国家自然科学基金(81471745) （81471745）
首都临床特色应用研究与成果推广(Z151100004015219) （Z151100004015219）
