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[不同形式运动病理学中电刺激及损毁小脑齿状核腹外侧部的临床生理效应]

[Clinical physiological effects of electrostimulation and destruction of the ventrolateral portions of the cerebellar dentate nuclei in different forms of motor pathology].

作者信息

Vasin N I, Lesov N S, Maĭorchik V E, Arkhipova N A, Safronov V A

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 1977 Jul-Aug(4):12-21.

PMID:302544
Abstract

The effect of electrostimulation and destruction of the ventrolateral parts of the cerebellar dentate nuclei is described on the basis of 27 dentotomies performed on patients with different forms of motor pathology. The dento-cortical connections were studied by advancing electrodes to the cerebral and cerebellar cortex through trephination openings made in the postero-frontal-parasagittal area for ventriculography and in the occipital area for the insertion of a stereotaxic cannula. It was found that the principal test for operative identification of the ventro-oral parts of the dentate nucleus in electrostimulation are motor reactions and changes in the muscular tonus in the homolateral limbs and reactions of the cortex of the central and precentral areas of the cerebral hemispheres revealed by electrocorticography. The main clinical effect produced by the destruction of these parts of the dentate nuclei is diminution of the spastic component of muscular hypertonus; hardly any effect is caused on the rigidity component. Redistribution of muscular tonus is among the factors inducing postoperative changes in hyperkinesia.

摘要

在对患有不同形式运动病理学的患者进行27次齿状核切开术的基础上,描述了电刺激和破坏小脑齿状核腹外侧部分的效果。通过在额后矢状旁区域为脑室造影术制作的环锯开口以及在枕部区域为插入立体定向套管而将电极推进到大脑和小脑皮质,研究了齿状核与皮质的连接。结果发现,在电刺激中用于手术识别齿状核腹口部的主要测试是运动反应、同侧肢体肌肉张力的变化以及通过皮层脑电图揭示的大脑半球中央和中央前区皮质的反应。破坏齿状核这些部分产生的主要临床效果是肌肉张力亢进的痉挛成分减轻;对强直成分几乎没有影响。肌肉张力的重新分布是导致术后运动亢进变化的因素之一。

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