Bennett K M, O'Sullivan J D, Peppard R F, McNeill P M, Castiello U
Faculty of Health Sciences, La Trobe University, Melbourne, Australia.
J Neurol Neurosurg Psychiatry. 1998 Oct;65(4):479-87. doi: 10.1136/jnnp.65.4.479.
To assess postoperative effects of unilateral posteroventral pallidotomy on the organisation of upper limb movement.
A three dimensional kinematic system (ELITE, B/T/S/ Italy) was used to record reach to grasp movements to objects of either small (0.7 cm) or large (8 cm) diameter placed at a reaching distance of either 20 or 30 cm. Four patients with Parkinson's disease were assessed in "off" (12 hours without medication) and "on" (1 hour after administration of medication) preoperatively and postoperatively.
Duration of the movement and the time spent in arm deceleration were significantly reduced after surgery. However, movement patterning according to object size was adversely affected. Postoperatively, all four patients showed an abnormal pattern of a longer movement duration, and three showed a longer time of reaching arm deceleration, for reach to grasp movements to the large object than for those to the small object.
Posteroventral pallidotomy seems to be beneficial in reducing bradykinesia of upper limb movements but may have "costs" to movement patterning, particularly for reach to grasp movements to objects of differing sizes. This study raises interesting questions about the role of the globus pallidus interna in coordinating stimulus bound visual information with appropriate motor patterning.
评估单侧后腹侧苍白球切开术对上肢运动组织的术后效果。
使用三维运动学系统（ELITE，意大利B/T/S公司）记录对放置在20厘米或30厘米伸手可及距离处的小直径（0.7厘米）或大直径（8厘米）物体的抓握动作。对4例帕金森病患者在术前和术后的“关”期（停药12小时）和“开”期（服药1小时后）进行评估。
术后运动持续时间和手臂减速时间显著缩短。然而，根据物体大小的运动模式受到不利影响。术后，所有4例患者抓握大物体的动作持续时间均出现异常延长，3例患者抓握大物体时手臂减速时间长于抓握小物体时。
后腹侧苍白球切开术似乎有助于减轻上肢运动的运动迟缓，但可能对运动模式产生“代价”，特别是对于抓握不同大小物体的动作。本研究提出了关于内侧苍白球在将刺激相关视觉信息与适当运动模式协调中的作用的有趣问题。
