帕金森病中丘脑底核刺激：有源电极触点与术中微记录的相关性
Subthalamic nucleus stimulation in Parkinson's disease: correlation of active electrode contacts with intraoperative microrecordings.
作者信息
Hamel W, Fietzek U, Morsnowski A, Schrader B, Weinert D, Müller D, Deuschl G, Mehdorn H M
机构信息
Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany.
出版信息
Stereotact Funct Neurosurg. 2003;80(1-4):37-42. doi: 10.1159/000075158.
BACKGROUND/AIMS: The most effective site for subthalamic nucleus (STN) stimulation has remained unclear. The position of active contacts relative to the dorsal margin of the STN was determined.
METHODS
Electrodes (n = 49) were implanted following STN mapping by microrecording and microstimulation along five tracks (n = 25 patients). The stereotactic position of active contacts was determined and correlated with microrecordings using an algorithm for direct three-dimensional comparisons (n = 37).
RESULTS
Most active contacts were detected within +/-1.0 mm from the dorsal margin of the STN as defined by microrecording (32.4%) or farther dorsal in the subthalamic area (37.8%), and only 29.7% were localized to the STN proper. This was consistent with the average stereotactic coordinates of the active contacts in these three groups.
CONCLUSION
Our data suggest that the dorsal border area of the STN is the most effective target. Besides the dorsolateral STN (sensorimotor part) this may include projections from/to STN, the zona incerta, and pallidofugal projections in the fields of Forel.
背景/目的：丘脑底核（STN）刺激的最有效部位仍不明确。确定了有效触点相对于STN背侧边缘的位置。
方法
通过微记录和微刺激沿五条轨迹对STN进行映射后植入电极（n = 49）（n = 25例患者）。使用直接三维比较算法确定有效触点的立体定向位置，并将其与微记录相关联（n = 37）。
结果
如通过微记录所定义，大多数有效触点在距STN背侧边缘±1.0 mm范围内被检测到（32.4%），或在丘脑底区域更靠背侧（37.8%），只有29.7%定位于STN本身。这与这三组中有效触点的平均立体定向坐标一致。
结论
我们的数据表明，STN的背侧边界区域是最有效的靶点。除了背外侧STN（感觉运动部分），这可能包括来自/至STN的投射、未定带以及Forel区的苍白球传出投射。
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