Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Key Laboratory of Neurodegenerative Diseases, Capital Medical University, Ministry of Education, No 45, Changchun Street, Xuanwu, Beijing 100053, China.
Parkinsonism Relat Disord. 2013 Jan;19(1):109-14. doi: 10.1016/j.parkreldis.2012.08.005. Epub 2012 Sep 12.
Subthalamic nucleus deep brain stimulation (STN DBS) is an effective surgical treatment for Parkinson's disease (PD). Recent studies demonstrated that pathological oscillations are seen largely within the dorsolateral portion of the STN, which is the same location that predicts optimal therapeutic benefit with DBS; however, the precise nature of the relationship between these two phenomena remains unclear. The purpose of this study was to explore localization of oscillatory activity in relation to the optimal contacts of DBS which results in the best motor improvement. We studied 23 PD patients who underwent electrode implantation into the STN for motor symptoms. Microelectrode recordings were taken from the STN during surgery and neuronal activity was analyzed offline. Spectral characteristics were calculated. Clinical outcomes were evaluated pre- and post-STN DBS implantation using the Unified Parkinson's Disease Rating Scale (UPDRS III). The position of optimal electrode contacts was assessed by postoperative magnetic resonance imaging (MRI) and was compared to the location of oscillatory activity within the STN as well as its dorsal margin (where STN neuronal activity was first detected). Of the total 188 neurons obtained, 51 (27.1%) neurons showed significant oscillatory activity. Of those, 47 (92.2%) were localized in the dorsal portion of the STN. Furthermore, there was no significant difference between the averaged coordinates of the position of 40 optimal contacts and the coordinates of the dorsal margin of the STN. The data indicate that the positions of the best contacts correlate with the locations of the oscillatory neurons supporting the prediction that stimulation of the dorsolateral oscillatory region leads to an effective clinical outcome for STN DBS surgery.
底丘脑核深部脑刺激（STN DBS）是治疗帕金森病（PD）的有效手术方法。最近的研究表明，病理性振荡主要出现在 STN 的背外侧部分，这与 DBS 预测的最佳治疗效果的位置相同；然而，这两种现象之间的确切关系仍不清楚。本研究旨在探索与 DBS 最佳刺激接触相关的振荡活动的定位，以获得最佳的运动改善效果。我们研究了 23 名接受 STN 电极植入以治疗运动症状的 PD 患者。在手术过程中从 STN 中采集微电极记录，并离线分析神经元活动。计算光谱特征。使用统一帕金森病评定量表（UPDRS III）在 STN DBS 植入术前和术后评估临床结果。通过术后磁共振成像（MRI）评估最佳电极接触的位置，并将其与 STN 内的振荡活动及其背缘（首次检测到 STN 神经元活动的位置）的位置进行比较。在总共获得的 188 个神经元中，有 51 个（27.1%）神经元表现出明显的振荡活动。其中，47 个（92.2%）位于 STN 的背侧部分。此外，40 个最佳接触位置的平均坐标与 STN 背缘的坐标之间没有显著差异。这些数据表明，最佳接触位置与振荡神经元的位置相关，这支持了刺激背外侧振荡区域可导致 STN DBS 手术有效临床结果的预测。
