Tai Chun-Hwei, Kuo Chung-Chin
Department of Neurology, College of Medicine and University Hospital, National Taiwan University, Taipei.
Acta Neurol Taiwan. 2006 Sep;15(3):206-16.
Subthalamic nucleus (STN) has been known to play an important role in the regulation of cortico-basal ganglia-thalamo-cortical loop. STN neurons have pacemaking activitiy and their firing pattern can switch from spike mode to bursting mode when membrane potential becomes hyperpolarized. Recent study has shown that STN neurons show marked increase in burst and oscillatory activity during the dopamine-depleting state of Parkinson's disease (PD). This electrophysiological change in activity is now considered as an characterstic pathophysiological feature of PD. High frequency stimulation of STN can modify and "normalize" the activity of STN neurons in the pathophysiologial state. This electrophysiological treatment applied to STN, known as deep brain stimulation (DBS) clinically, ameliorates the symptoms of PD effectively, and is becoming a standard treatment in patients with advanced PD. This article would review the basic researches concerning electrical activities of STN and try to extend the basic knowledge into clinical applications.
已知丘脑底核(STN)在调节皮质-基底神经节-丘脑-皮质环路中起重要作用。STN神经元具有起搏活动,当膜电位超极化时,其放电模式可从单峰模式转变为爆发模式。最近的研究表明,在帕金森病(PD)的多巴胺耗竭状态下,STN神经元的爆发和振荡活动显著增加。这种活动的电生理变化现在被认为是PD的一个特征性病理生理特征。高频刺激STN可以改变病理生理状态下STN神经元的活动并使其“正常化”。这种应用于STN的电生理治疗,临床上称为深部脑刺激(DBS),能有效改善PD的症状,并正成为晚期PD患者的标准治疗方法。本文将综述有关STN电活动的基础研究,并试图将这些基础知识扩展到临床应用中。