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[术中微记录引导下对丘脑底核进行术中空间定位的脑深部电刺激的有效性。两例报告]

[The effectiveness of deep brain stimulation with intraoperative spatial mapping of subthalamic nucleus using intraoperative microrecording. Report of two cases].

作者信息

Sobstyl Michał, Dzierzecki Sebastian, Zabek Mirosław, Koziara Henryk, Kadziołka Bartosz, Mossakowski Zbigniew

机构信息

Klinika Neurochirurgii, Centrum Medycznego Kształcenia Podyplomowego w Warszawie, Warszawa.

出版信息

Neurol Neurochir Pol. 2007 Jan-Feb;41(1):76-81.

Abstract

The aims of the study were to present the surgical technique of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) and to analyze our experience with the MedtronicStealthStation Treon neuronavigation system and Framelink 4.1 software in targeting STN using single-unit extracellular action potentials (microrecording). The prospective study included 2 patients with bilateral STN DBS. The STN boundaries were mapped using microrecording, without microstimulation and recording of kinesthetic cells. For macrostimulation the longest trajectory with neuronal activity characteristic of STN was chosen. The patients were assessed using Unified Parkinson's Disease Rating Scale UPDRS version 3 and Schwab and England Scale. Postoperatively we did not notice intracerebral haemorrhage. Also there were no transient or permanent side effects. The mean number of microelectrode tracts was 4 per STN. Framelink 4.1 software is reliable to plan individual microelectrode trajectories and help avoid the intraparenchymal vessels.

摘要

本研究的目的是介绍双侧丘脑底核(STN)深部脑刺激(DBS)的手术技术,并分析我们使用美敦力StealthStation Treon神经导航系统和Framelink 4.1软件,通过单单位细胞外动作电位(微记录)靶向STN的经验。这项前瞻性研究纳入了2例接受双侧STN DBS的患者。使用微记录绘制STN边界,未进行微刺激和运动觉细胞记录。对于宏观刺激,选择具有STN神经元活动特征的最长轨迹。使用统一帕金森病评定量表(UPDRS)第3版和施瓦布与英格兰量表对患者进行评估。术后我们未发现脑出血。也没有出现短暂或永久性副作用。每个STN的微电极束平均数量为4条。Framelink 4.1软件在规划个体微电极轨迹和帮助避免脑实质内血管方面是可靠的。

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