PALLIDOTOMY INCREASES ACTIVITY OF MOTOR ASSOCIATION CORTEX IN PARKINSONS-DISEASE - A POSITRON EMISSION TOMOGRAPHIC STUDY
PALLIDOTOMY INCREASES ACTIVITY OF MOTOR ASSOCIATION CORTEX IN PARKINSONS-DISEASE - A POSITRON EMISSION TOMOGRAPHIC STUDY
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DOI：
10.1002/ana.410370611
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发表时间：
1995-06-01
影响因子：
11.2
通讯作者：
COULDWELL, W
中科院分区：
文献类型：
--
作者：
GRAFTON, ST;WATERS, C;COULDWELL, W
立体定向后腹侧苍白球切开术可改善帕金森病患者的运动能力。抑制性苍白体投射到腹侧丘脑的中断，皮层-基底节区运动回路的组成部分允许这种临床益处。我们假设苍白球切开术会导致接受腹外侧丘脑投射的运动皮质区域的运动相关活动增加。在6名接受立体定向后腹侧苍白球切开术的帕金森病患者中进行了测试。每位患者在执行简单的抓取任务时和休息时都使用正电子发射断层扫描（PET）测量区域脑血流量（rCBF）。手术前和手术后17周进行扫描。苍白球切除术后，辅助运动区（SMA）和运动前皮层rCBF的运动相关变化均显著增加，而原发性运动皮层rCBF的运动相关变化未见显著增加。研究结果证明了丘脑苍白区回路在调节意志运动中的重要性，并证实了腹侧丘脑抑制性输入的中断可以增强运动关联区域的运动相关活动。
Stereotactic posteroventral pallidotomy can improve motor performance in Parkinson's disease. Interruption of inhibitory pallidal projections to ventrolateral thalamus, components of a cortical-basal ganglia motor loop allows for this clinical benefit. We hypothesized that pallidotomy would lead to increased movement related activity in motor cortical areas receiving projections from ventrolateral thalamus. This was tested in 6 Parkinson's disease patients who underwent stereotactic posteroventral pallidotomy. Each patient was imaged with positron emission tomography (PET) measures of regional cerebral blood how (rCBF) during performance of a simple prehension task and at rest. Scans were acquired before and 17 weeks after surgery. After pallidotomy, movement-related changes of rCBF increased significantly in both the supplementary motor area (SMA) and premotor cortex but not in primary motor cortex. The results demonstrate the importance of pallidothalamic circuitry for regulating volitional movements and confirm that disruption of inhibitory input to the ventrolateral thalamus can augment movement-related activity in motor association areas.