Li Xiaoyu, Zhuang Ping, Li Yongjie
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University Beijing, China.
Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University Beijing, China.
Front Hum Neurosci. 2015 Nov 25;9:630. doi: 10.3389/fnhum.2015.00630. eCollection 2015.
Levodopa therapy alleviates the symptoms of Parkinson's disease (PD), but long-term treatment often leads to motor complications such as levodopa-induced dyskinesia (LID).
To explore the neuronal activity in the basal ganglia nuclei in patients with PD and LID.
Thirty patients with idiopathic PD (age, 55.1 ± 11.0 years; disease duration, 8.7 ± 5.6 years) were enrolled between August 2006 and August 2013 at the Xuanwu Hospital, Capital Medical University, China. Their Hoehn and Yahr (1967) scores ranged from 2-4 and their UPDRS III scores were 28.5 ± 5.2. Fifteen of them had severe LID (UPDRS IV scores of 6.7 ± 1.6). Microelectrode recording was performed in the globus pallidus internus (GPi) and subthalamic nucleus (STN) during pallidotomy (n = 12) or STN deep brain stimulation (DBS; bilateral, n = 12; unilateral, n = 6). The firing patterns and frequencies of various cell types were analyzed by assessing single cell interspike intervals (ISIs) and the corresponding coefficient of variation (CV).
A total of 295 neurons were identified from the GPi (n = 12) and STN (n = 18). These included 26 (8.8%) highly grouped discharge, 30 (10.2%) low frequency firing, 78 (26.4%) rapid tonic discharge, 103 (34.9%) irregular activity, and 58 (19.7%) tremor-related activity. There were significant differences between the two groups (p < 0.05) for neurons with irregular firing, highly irregular cluster-like firing, and low-frequency firing.
Altered neuronal activity was observed in the basal ganglia nucleus of GPi and STN, and may play important roles in the pathophysiology of PD and LID.
左旋多巴疗法可缓解帕金森病（PD）的症状，但长期治疗常导致运动并发症，如左旋多巴诱导的异动症（LID）。
探讨帕金森病合并左旋多巴诱导的异动症患者基底神经节核团的神经元活动。
2006年8月至2013年8月，在中国首都医科大学宣武医院招募了30例特发性帕金森病患者（年龄55.1±11.0岁；病程8.7±5.6年）。他们的Hoehn和Yahr（1967年）评分在2至4分之间，统一帕金森病评定量表第三部分（UPDRS III）评分为28.5±5.2。其中15例有严重的左旋多巴诱导的异动症（UPDRS第四部分评分为6.7±1.6）。在苍白球毁损术（n = 12）或丘脑底核深部脑刺激术（DBS；双侧，n = 12；单侧，n = 6）期间，对内侧苍白球（GPi）和丘脑底核（STN）进行微电极记录。通过评估单细胞峰间间隔（ISI）和相应的变异系数（CV）来分析各种细胞类型的放电模式和频率。
从内侧苍白球（n = 12）和丘脑底核（n = 18）共识别出295个神经元。其中包括26个（8.8%）高度成组放电、30个（10.2%）低频放电、78个（26.4%）快速强直放电、103个（34.9%）不规则活动和58个（19.7%）震颤相关活动。两组之间在不规则放电、高度不规则簇状放电和低频放电的神经元方面存在显著差异（p < 0.05）。
在内侧苍白球和丘脑底核的基底神经节核团中观察到神经元活动改变，这可能在帕金森病和左旋多巴诱导的异动症的病理生理学中起重要作用。
