Mrakic-Sposta Simona, Marceglia Sara, Egidi Marcello, Carrabba Giorgio, Rampini Paolo, Locatelli Marco, Foffani Guglielmo, Accolla Ettore, Cogiamanian Filippo, Tamma Filippo, Barbieri Sergio, Priori Alberto
Dipartimento di Scienze Neurologiche, Università di Milano, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano 20122, Italy.
J Clin Neurosci. 2008 May;15(5):559-67. doi: 10.1016/j.jocn.2007.02.091.
Intraoperative neuronal microrecordings can help in localizing the subthalamic nucleus (STN) during stereotactic neurosurgery for deep-brain stimulation (DBS) in Parkinson's disease. To obtain quantitative information on neuronal spike descriptors, we systematically analysed neuronal spikes in the STN and substantia nigra pars reticulata (SNr) in 31 sides of the brain in awake patients undergoing stereotactic neurosurgery for DBS electrode implantation. In these two structures we evaluated spike amplitude, area, duration, rise time and mean total firing rate. The recording spike density was higher in the STN than in the SNr (94% vs. 28%). Microelectrode recordings showed a larger spike area and amplitude in the SNr than in the STN ([mean+/-SD] amplitude: 46.7+/-31.1 vs. 36.3+/-29.6 microV; area: 25.6+/-24.2 vs. 36.7+/-21.4 microVmsec), a higher total firing rate at rest in the SNr than in the STN (78.6+/-53.5 vs. 61.9+/-40.8 Hz), and a longer duration and rise time in the SNr than in the STN (duration: 2.0+/-1 vs. 1.3+/-0.6 ms; rise time: 0.95+/-0.6 vs. 0.67+/-0.3 ms). Our analysis also revealed sex-related differences in the studied spike descriptors, paralleling recent findings from deep electroencephalography recordings. In the STN, males had larger spike area and amplitude (amplitude: 41.97+/-32.57 vs. 26.2+/-19.7 microV; area: 31.8+/-26.4 vs. 13.0+/-10.6 microVmsec), whereas females had higher mean total firing rate (66.7+/-53.4 vs. 82.8+/-50.8 Hz). Our results have implications for clinical practice and the development of algorithms for the neurophysiological identification of the STN during stereotactic neurosurgery for Parkinson's disease, based on the on-line automated computation of multiple spike-variables.
术中神经元微记录有助于在帕金森病的立体定向神经外科手术中进行脑深部电刺激（DBS）时定位丘脑底核（STN）。为了获取有关神经元放电峰电位描述符的定量信息，我们系统分析了31例接受DBS电极植入的清醒患者脑内STN和黑质网状部（SNr）的神经元放电峰电位。在这两个结构中，我们评估了放电峰电位的幅度、面积、持续时间、上升时间和平均总放电频率。STN的记录放电峰电位密度高于SNr（94%对28%）。微电极记录显示，SNr的放电峰电位面积和幅度大于STN（[平均值±标准差]幅度：46.7±31.1对36.3±29.6 μV；面积：25.6±24.2对36.7±21.4 μVmsec），SNr静息时的总放电频率高于STN（78.6±53.5对61.9±40.8 Hz），SNr的持续时间和上升时间长于STN（持续时间：2.0±1对1.3±0.6 ms；上升时间：0.95±0.6对0.67±0.3 ms）。我们的分析还揭示了所研究的放电峰电位描述符存在性别差异，这与最近深部脑电图记录的结果一致。在STN中，男性的放电峰电位面积和幅度更大（幅度：41.97±32.57对26.2±19.7 μV；面积：31.8±26.4对13.0±10.6 μVmsec），而女性的平均总放电频率更高（66.7±53.4对82.8±50.8 Hz）。我们的结果对于临床实践以及基于多个放电峰电位变量的在线自动计算在帕金森病立体定向神经外科手术中进行STN神经生理学识别的算法开发具有重要意义。
