Nishimura H, Hirai T
Department of Neurosurgery, Kochi Medical School, Japan.
No To Shinkei. 1993 Feb;45(2):144-55.
We have developed a new operational method for stereotactic functional neurosurgery using MRI stereotaxy combined with microelectrode recording. MRI stereotaxy shows us the individual variations of thalamic configurations. The tentative target points were determined using the MRI stereotaxy assisted software system which revised the distortion of MRI images. Consequently, the accuracy and safety of the microelectrode recording were increased. This, in turn, increased the accuracy of stereotactic thalamotomy while producing encouraging operational outcomes. The effectiveness of stereotactic thalamotomy for Parkinson's disease was confirmed by these excellent operative results. The symptoms improved and the dosage of medications, including L-DOPA, decreased. Furthermore, our results indicate that the distributing area of deep sensory neurons in the thalamus extended more posteriorly and upward than previously expected. Therefore, the functional and anatomical similarity between the human and monkey thalamus was reaffirmed. In this report, based on the above data, we reevaluated the neural mechanism of tremor and the role of stereotactic functional neurosurgery for Parkinson's disease.
我们开发了一种新的立体定向功能神经外科手术操作方法,该方法将MRI立体定位与微电极记录相结合。MRI立体定位向我们展示了丘脑结构的个体差异。使用校正MRI图像失真的MRI立体定位辅助软件系统确定暂定靶点。因此,提高了微电极记录的准确性和安全性。这反过来又提高了立体定向丘脑切开术的准确性,同时产生了令人鼓舞的手术效果。这些出色的手术结果证实了立体定向丘脑切开术治疗帕金森病的有效性。症状得到改善,包括左旋多巴在内的药物剂量减少。此外,我们的结果表明,丘脑中深部感觉神经元的分布区域比先前预期的更向后和向上延伸。因此,再次证实了人类和猴子丘脑之间的功能和解剖学相似性。在本报告中,基于上述数据,我们重新评估了震颤的神经机制以及立体定向功能神经外科手术在帕金森病中的作用。