Lehman R M, Zheng J, Hamilton J L, Micheli-Tzanako E
Division of Neurosurgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
Acta Neurochir (Wien). 2000;142(3):319-28. doi: 10.1007/s007010050041.
A quantitative on-line analysis of electrical activity in the pallidum of Parkinsonian patients has been developed to determine the focal point of lesioning. Additional recordings are made after the lesioning, to assess residual neural activity. A 3-D volume stereoscopic image system is proposed to display the complex anatomy and to superimpose the electrophysiological data into this system. The purpose of this study is to understand the complex pathophysiology in real-time anatomic/image space and determine the location and effect of lesioning residual energy sites.
Thirty patients undergoing 41 pallidotomies are presented. Neuronal activity from the pallidum is recorded using a semi-microelectrode. Based on this activity, lesioning is performed. Post-lesion recordings are made to determine the necessity of additional lesioning. 3-D volume MR images are acquired pre and postoperatively and compared for accuracy of lesion sites. A 3-D stereoscopic image system has been developed to depict basal ganglia geometry in the last 5 patients. Electrophysiological data are superimposed on this image system to show the surgeon the virtual position of the electrode tip.
A stereoscopic 3-D volume MR image system has been developed. This system more efficiently and accurately visualizes and records the coordinates of high neural activity in the pallidum and post lesion residual activity. Post-lesion power analysis was carried out in 30 patients. Additional lesions were indicated in 8 and different trajectories in 6.
Real-time visualization of neural recording, both pre and post-lesioning during pallidotomy, facilitates the surgeon's understanding of the spatiotemporal relationships of pathophysiological properties within the globus pallidus.
已开发出一种对帕金森病患者苍白球电活动进行定量在线分析的方法，以确定损伤的焦点。在损伤后进行额外记录，以评估残余神经活动。提出了一种三维容积立体图像系统，用于显示复杂的解剖结构，并将电生理数据叠加到该系统中。本研究的目的是在实时解剖/图像空间中理解复杂的病理生理学，并确定损伤残余能量部位的位置和影响。
介绍了30例接受41次苍白球切开术的患者。使用半微电极记录苍白球的神经元活动。基于此活动进行损伤。术后进行记录以确定是否需要额外的损伤。在术前和术后采集三维容积磁共振图像，并比较损伤部位的准确性。已开发出一种三维立体图像系统，用于描绘最后5例患者的基底神经节几何形状。将电生理数据叠加在该图像系统上，向外科医生显示电极尖端的虚拟位置。
已开发出一种立体三维容积磁共振图像系统。该系统能更高效、准确地可视化和记录苍白球中高神经活动的坐标以及损伤后的残余活动。对30例患者进行了损伤后功率分析。8例提示需要额外损伤，6例提示不同的轨迹。
在苍白球切开术期间，实时可视化损伤前后的神经记录，有助于外科医生理解苍白球内病理生理特性的时空关系。
