CAJ | 학술논문

目的探讨帕金森病(PD)与肌张力障碍(Dys)内苍白球(GPi)神经元振荡活动特点.方法 13例PD患者、6例Dys患者行GPi毁损术或刺激电极埋植术时应用微电极记录技术采集神经元电活动.峰间隔、峰间隔变异系数和功率谱分析神经元放电及振荡活动特点.结果在PD 124个神经元中40.3％伴有振荡活动,17.7％为震颤节律,22.6％为β节律,主要分布在距靶点3.5 mm处.在Dys 78个神经元中24.4％伴有振荡活动,14.1％为低频节律,10.3％为β节律,主要分布在距靶点6.1 mm处.β振荡活动神经元比例和频谱PD都高于Dys(P＜0.05).结论 GPi腹后侧是改善PD的最佳靶点,而背旁侧可能有效改善Dys,支持运动障碍病病理生理假说.
목적 탐토파금삼병(PD)여기장력장애(Dys)내창백구(GPi)신경원진탕활동특점.방법 13례PD환자、6례Dys환자행GPi훼손술혹자격전겁매식술시응용미전겁기록기술채집신경원전활동.봉간격、봉간격변이계수화공솔보분석신경원방전급진탕활동특점.결과 재PD 124개신경원중40.3％반유진탕활동,17.7％위진전절률,22.6％위β절률,주요분포재거파점3.5 mm처.재Dys 78개신경원중24.4％반유진탕활동,14.1％위저빈절률,10.3％위β절률,주요분포재거파점6.1 mm처.β진탕활동신경원비례화빈보PD도고우Dys(P＜0.05).결론 GPi복후측시개선PD적최가파점,이배방측가능유효개선Dys,지지운동장애병병리생리가설.
Objective To explore neuronal oscillatory activity in the globus pallidus internus (GPi) in patients with Parkinson's disease (PD) and dystonia (Dys).Methods 13 PD patients(M:10,F:3; mean age:60.3 ±4.5 years,mean disease duration:7.6 ±3.5 years) and 6 Dys patients (M:3,F:3; mean age:31.0 ± 10.9 years; mean disease duration:9.8 ± 6.0 years) who underwent pallidotomy or GPi deep brain stimulation(DBS) were studied.Microelectrode recordings in GPi were performed.Single-unit analysis,inter-spike interval(ISI) and coefficient of variation of ISI (CV) were applied.Power spectral analysis was used to evaluate neuronal oscillation.Results 124 neurons were identified from PD.Of these neurons,40.3％ neurons had oscillatory activity,17.7％ neurons discharged as same frequency as tremor (4.0 ～ 7.0 Hz) (TFB) oscillation and 22.6％ neurons discharged β frequency (8 ～ 30 Hz) (βFB) oscillation.Majority of these oscillatory neurons localized at a distance of 3.5 mm from the final target.78 neurons were identified from Dys.Of these neurons,24.4％ neurons had oscillatory activity,14.1％ neurons had low frequency(0.5 ～3.5 Hz) oscillation (LFB) and 10.3％ neurons had βFB oscillation.Most of them localized at a distance of 6.1 mm from the final target.The significant differences of the proportion of oscillatory neurons and neurons with βFB oscillation (40.3％ vs 24.4％ ;22.6％ vs.10.3％) as well as the frequency of βFB oscillatory activity (8-30 Hz vs.11 ～ 22 Hz) approached between PD and Dys(x2,P ＜ 0.05),respectively.Furthermore,the significant difference of mean neuronal firing rate reached between PD and Dys(75.4 ±25.8 vs.38.6 ±11.5) Hz(P ＜0.01).Conclusions The results support the view that the basal ganglia dysfunction is involved to the pathophysiology of PD and Dys.The localizations of oscillatory neuron within the GPi in PD and Dys indicate that the ventral portion of GPi is the best target for PD whereas the dorsal portion of GPi is likely to be effective for Dys.