Assessing the microlesion effect of subthalamic deep brain stimulation surgery with FDG PET
Assessing the microlesion effect of subthalamic deep brain stimulation surgery with FDG PET
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DOI：
10.3171/2008.12.jns08991
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发表时间：
2009-06-01
影响因子：
4.1
通讯作者：
Eidelberg, David
中科院分区：
文献类型：
--
作者：
Pourfar, Michael;Tang, Chengke;Eidelberg, David
Object.作者研究了在没有刺激的情况下，将脑深部刺激电极插入丘脑底核是否可以改变局部脑代谢。6例帕金森病（PD）患者术前行FDG PET扫描，并在植入双极电极后关闭刺激再次行FDG PET扫描。与基线值相比，在壳核/苍白球和腹侧丘脑的术后无刺激扫描中葡萄糖利用率降低（p < 0.01），感觉运动皮质和小脑的代谢增加（p < 0.005）。在FDG PET数据中测量的特定PD相关空间协方差模式的表达在电极植入后没有变化（p = 0.36），临床运动评分也没有显著变化（p = 0.44）。然而，电极植入后患者之间PD相关空间协方差模式表达的差异确实与术中放置的微电极记录轨迹的数量相关（r =-0.82，p < 0.05）。这些结果表明，电极植入可以对局部脑功能产生微损伤效应。尽管如此，这些局部变化并未超过实现临床获益所需的网络调节阈值。(DOI：10.3171/2008.12.JNS08991）
Object. The authors investigated whether the insertion of deep brain stimulation electrodes into the subthalamic nucleus can alter regional brain metabolism in the absence of stimulation.Methods. Six patients with Parkinson disease (PD) underwent preoperative FDG PET scanning, and again after STN electrode implantation with stimulation turned off.Results. Compared with baseline values, glucose utilization was reduced in the postoperative off-stimulation scans in the putamen/globus pallidus and in the ventral thalamus (p < 0.01), and there was increased metabolism in the sensorimotor cortex and cerebellum (p < 0.005). The expression of a specific PD-related spatial covariance pattern measured in the FDG PET data did not change after electrode implantation (p = 0.36), nor was there a significant change in clinical motor ratings (p = 0.44). Differences in PD-related spatial covariance pattern expression among the patients after electrode implantation did, however, correlate with the number of microelectrode recording trajectories placed during surgery (r = -0.82, p < 0.05).Conclusions. These findings Suggest that electrode implantation can impart a microlesion effect on regional brain function. Nonetheless, these local changes did not cross the threshold of network modulation needed to achieve clinical benefit. (DOI: 10.3171/2008.12.JNS08991)