Chronic subthalamic high-frequency deep brain stimulation in Parkinson's disease - a histopathological study
Chronic subthalamic high-frequency deep brain stimulation in Parkinson's disease - a histopathological study
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DOI：
10.1111/j.1468-1331.2006.01569.x
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发表时间：
2007-02-01
影响因子：
5.1
通讯作者：
Ostergaard, K.
中科院分区：
文献类型：
--
作者：
Nielsen, M. S.;Bjarkam, C. R.;Ostergaard, K.
本研究描述了一名帕金森病 (PD) 患者在死亡前 29 个月接受双侧丘脑底高频深部脑刺激 (STN DBS) 治疗后的大脑病理结果。常规神经病理学检查后，将包含电极束、丘脑底核（STN）、黑质和前额皮质的组织块石蜡包埋，切成5μm厚的连续切片，并用多种常规染色方法和免疫组化染色。双侧黑质脱色、细胞丢失和路易体形成证实了 PD 的诊断。显微镜评估进一步确认了电极在 STN 中的位置。电极束被一个 150 微米宽的胶质纤维酸性蛋白（GFAP）阳性胶囊包围，该胶囊由衬在电极束管腔内的薄胶原层组成，而细胞和轴突较少的区域构成朝向周围正常脑组织的胶囊壁。囊边界外的脑组织看起来正常，刺激区域与未刺激区域相比没有差异。我们的结果与之前在 STN DBS 几个月后进行的研究一致，表明电极束附近有轻微的组织病理学变化，似乎是由电极放置引起的，而不是由电刺激引起的。
This study describes the pathological findings in the brain of a patient with Parkinson's disease (PD) treated with bilateral subthalamic high-frequency deep brain stimulation (STN DBS) for 29 months prior to death. After routine neuropathological examination, tissue blocks containing the electrode tracts, the subthalamic nucleus (STN), the substantia nigra and the pre-frontal cortex were paraffin embedded and cut into 5-mu m-thick serial sections and stained with several conventional staining methods and immunohistochemistry. Bilateral nigral depigmentation, cell loss and Lewy body formation confirmed the diagnosis of PD. Microscopic evaluation furthermore confirmed the location of the electrodes in the STN. The electrode tracts were surrounded by a 150-mu m-wide glial fibrillary acidic protein (GFAP)-positive capsule consisting of a thin collagen layer lining the lumen of the tract, whilst an area with few cells and axons constituted the capsule wall towards the surrounding normal brain tissue. The brain tissue appeared normal outside the capsule boundaries with no difference in areas of stimulation compared with areas of no stimulation. Our results correspond with previous studies performed after fewer months of STN DBS and indicate mild histopathological changes in the vicinity of the electrode tract, appearing to result from the electrode placement and not from the electrical stimulation.