Neuronal firing in the globus pallidus internus and the ventrolateral thalamus related to parkinsonian motor symptoms
Neuronal firing in the globus pallidus internus and the ventrolateral thalamus related to parkinsonian motor symptoms作者机构：Beijing Institute of Functional Neurosurgery Department of Neurology Xuanwu Hospital Capital Medical University Beijing 100053 China
出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)
年 卷 期：2009年第122卷第19期
页 面：2308-2314页
核心收录：
基 金：The study was supported by grants of National Natural Science Foundation of China （No.30370473 30770746）.We would like to thank Drs. HU Yong-sheng ZHU Hong-wei TAO Wei YU Tao MA Kai YAN Xiao-ming ZHANG Xiao-hua and CA1 Li-xin who were assistants at different stages of the study.
主 题：Parkinson＇s disease movement disorders globus pallidus thalamus microelectrodes
摘 要：Background It has been proposed that parkinsonian motor signs result from hyperactivity in the output nucleus of the basal ganglia, which suppress the motor thalamus and cortical areas. This study aimed to explore the neuronal activity in the globus pallidus internus （GPi） and the ventrolateral thalamic nuclear group （ventral oral posterior/ventral intermediate, Vop/Vim） in patients with Parkinson＇s disease （PD）. Methods Twenty patients with PD who underwent neurosurgery were studied. Microelectrode recording was performed in the GPi （n=10） and the Vop/Vim （n=10） intraoperatively. Electromyography （EMG） contralateral to the surgery was simultaneously performed. Single unit analysis was carried out. The interspike intervals （ISI） and coefficient of variation （CV） of ISI were calculated. Histograms of ISI were constructed. A unified Parkinson＇s disease rating scale （UPDRS） was used to assess the clinical outcome of surgery. Results Three hundred and sixty-three neurons were obtained from 20 trajectories. Of 175 GPi neurons, there were 15.4% with tremor frequency, 69.2% with tonic firing, and 15.4% with irregular discharge. Of 188 thalamic neurons, there were 46.8% with tremor frequency, 22.9% with tonic firing, and 30.3% with irregular discharge. The numbers of three patterns of neuron in GPi and Vop/Vim were significantly different （P 〈0.001）. ISI analysis revealed that mean firing rate of the three patterns of GPi neurons was （80.9±63.9） Hz （n=78）, which was higher than similar neurons with 62.9 Hz in a normal primate. For the Vop/Vim group, ISI revealed that mean firing rate of the three patterns of neurons （n=95） was （23.2±17.1） Hz which was lower than similar neurons with 30 Hz in the motor thalamus of normal primates. UPDRS indicated that the clinical outcome of pallidotomy was （64.3±29.5）%, （83.4±19.1）% and （63.4±36.3）%, and clinical outcome of thalamotomy was （92.2±12.9）%, （68.0±25.2）% and （44.3±7.2）% for tremor, rigidity and bradykinesia, respectively. A significant difference of tremor and rigidity was found between GPi and VopNim （P 〈0.05）. Conclusions Different changes in neuronal firing rate and the pattern in GPi and Vop/Vim are likely responsible for parkinsonian motor signs. The results support the view that abnormal neuronal activity in GPi and Vop/Vim are involved in the pathophysiology of parkinsonism.
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