帕金森及肌张力障碍患者丘脑底核脑深部电刺激术中的治疗靶点定位

发布时间：2018-06-23 04:16

本文选题：脑深部电刺激 + 丘脑底核　；参考：《山东医药》2017年11期

【摘要】：目的探讨帕金森及肌张力障碍患者丘脑底核(STN)脑深部电刺激术(DBS)前用MRI和电生理刺激确定治疗靶点的可行性。方法选择202例(共382侧)接受STN-DBS治疗的帕金森及肌张力障碍患者,术前在MRI上确定STN核团位置,作为治疗靶点,STN-DBS术前开颅后行电生理检测STN电信号,明确靶点定位是否准确。结果 1术前MRI上STN核团定位清晰288侧、尚可72侧、不清22侧。2382侧开颅后电生理检测记录到STN电生理信号,339侧首次穿刺即记录到STN信号,43侧更换靶点后再次穿刺记录到STN信号,其中356侧记录到典型STN电信号,26侧STN电信号不典型。STN信号长度(5.9±1.1)mm。3术前MRI上STN核团定位满意(清晰或尚可的360侧中,341侧(94.7%)术前电生理检测记录到典型STN电信号;术前STN核团定位不清的22侧中术中15侧(68.2%)术前电生理检测探及典型STN信号。结论对于帕金森及肌张力障碍患者,术前MRI扫描联合电生理检测可精确定位STN-DBS术的治疗靶点。
[Abstract]:Objective to investigate the feasibility of using MRI and electrophysiological stimulation before deep brain stimulation (DBS) in patients with Parkinson's disease and dystonia. Methods 202 cases (382 sides) of Parkinson's disease and dystonia treated with STN-DBS were selected. The location of STN nuclei was determined on MRI before operation, and the electrophysiological examination of STN electrical signals was performed after craniotomy for STN-DBS to determine whether the target location was accurate or not. Results (1) the localization of STN nuclei on MRI was clear in 288 sides, in 72 sides, and in 22 sides. The electrophysiological signals of STN were recorded in 339 sides after craniotomy. STN signals were recorded in 43 sides after replacement of targets, and STN signals were recorded again after replacement of targets. The typical STN signals were recorded in 356 sides and 26 sides (5.9 卤1.1). The typical electrophysiological signals were recorded in 341 (94.7%) of 360 sides (94.7%). 15 (68.2%) of 22 sides with unclear localization of STN nuclei were detected by preoperative electrophysiological examination and typical STN signals were detected. Conclusion for patients with Parkinson's and dystonia, preoperative MRI combined with electrophysiological examination can accurately locate the therapeutic targets of STN-DBS.
【作者单位】：首都医科大学附属北京天坛医院;北京市神经外科研究所;
【基金】：国家自然科学基金资助项目(81301183) 北京市医管局临床医学发展专项基金(ZYLX201305)
【分类号】：R742.5

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