Taha J M, Favre J, Baumann T K, Burchiel K J
Division of Neurosurgery, Oregon Health Sciences University, Portland, USA.
J Neurosurg. 1996 Dec;85(6):1005-12. doi: 10.3171/jns.1996.85.6.1005.
Information is limited on the characteristics and topographic localization of pallidal kinesthetic cells in patients with Parkinson's disease. The authors analyzed the data from 298 neurons recorded in 38 patients with Parkinson's disease who underwent pallidotomy via microrecording techniques. Sixty-five neurons (22%) responded to passive movement of contralateral limbs. Of 17 kinesthetic cells that were tested in six patients, seven (41%) responded to ipsilateral limb movement as well. Nineteen cells (6%) fired synchronously with tremor. More kinesthetic cells were activated (63%) than inhibited (28%) by movement of single (68%) rather than multiple (32%) joints, and proximal (75%) rather than distal (25%) joints. The lateral globus pallidus externus (GPe) and medial globus pallidus internus (GPi) pallidal segments contained similar proportions of kinesthetic cells, activated or inhibited cells, arm- or leg-activated cells, and cells responding to single or multiple joints. Significantly more kinesthetic cells that responded to distal joints were recorded in GPi compared to GPe segments (p = 0.01). Arm and leg cells had similar characteristics pertaining to activation versus inhibition and responses to single, multiple, proximal, or distal joint movements. Arm and leg cells were somatotopically organized in GPi. Arm cells were clustered at the rostral and caudal segments of GPi and leg cells were clustered centrally. In GPe, leg cells were clustered at the caudal border. No somatotopic organization was identified for activated or inhibited cells; cells that responded to single, multiple, proximal, or distal joints; tremor-synchronous cells; or cells responding to specific joints within somatotopic arm or leg cells. It is concluded that kinesthetic cells provide a roadmap that localizes limb cells during pallidotomy. More studies are needed to identify the clinical significance of the different characteristics of kinesthetic cells.
关于帕金森病患者苍白球感觉运动细胞的特征和地形定位的信息有限。作者分析了38例接受苍白球切开术的帕金森病患者通过微记录技术记录的298个神经元的数据。65个神经元（22%）对侧肢体的被动运动有反应。在6例患者中测试的17个感觉运动细胞中，有7个（41%）对同侧肢体运动也有反应。19个细胞（6%）与震颤同步放电。与多关节（32%）相比，单关节（68%）运动激活的感觉运动细胞（63%）多于抑制的感觉运动细胞（28%），近端关节（75%）运动激活的感觉运动细胞多于远端关节（25%）运动激活的感觉运动细胞。外侧苍白球外部（GPe）和内侧苍白球内部（GPi）苍白球节段中感觉运动细胞、激活或抑制细胞、手臂或腿部激活细胞以及对单关节或多关节有反应的细胞的比例相似。与GPe节段相比，GPi节段中记录到的对远端关节有反应的感觉运动细胞明显更多（p = 0.01）。手臂和腿部细胞在激活与抑制以及对单关节、多关节、近端或远端关节运动的反应方面具有相似的特征。手臂和腿部细胞在GPi中呈躯体定位组织。手臂细胞聚集在GPi的头端和尾端节段，腿部细胞聚集在中央。在GPe中，腿部细胞聚集在尾端边界。未发现激活或抑制细胞、对单关节、多关节、近端或远端关节有反应的细胞、震颤同步细胞或在躯体定位手臂或腿部细胞内对特定关节有反应的细胞的躯体定位组织。得出的结论是，感觉运动细胞提供了一条在苍白球切开术中定位肢体细胞的路线图。需要更多的研究来确定感觉运动细胞不同特征的临床意义。
