Neurophysiological research to clarify mechanisms of deep brain stimulation therapy and setting the most effective stimulating parameter of deep brain stimulation.

基底神经节在人脑的运动控制中起着重要的作用。基底神经节的高频刺激可以减轻运动障碍的运动症状，例如帕金森病、特发性震颤和全身性肌张力障碍。然而，脑深部电刺激（DBS）的作用机制仍然知之甚少。确定哪一个精确的解剖位置是DBS电极的临床最有效部位是至关重要的。不幸的是，由于成像分辨率有限、脑深部结构位置的个体差异以及接触预期或非预期神经系统的扩散，难以获得该信息。生理学研究可能会有所帮助。在这项研究中，我们记录了术后与DBS电极接触永久植入基底神经节单极和双极记录不仅从一个位置，但也有几个位置。我们分析了DBS位置之间SEP幅度和相位的差异。我们还研究了整个感觉道病变患者的SEP。这些结果使我们更详细地了解DBS的有效部位与SEP电位之间的关系。此外，我们还从神经生理学的角度探讨了运动障碍的病理生理机制。我们证明了DTY 5患者运动皮层的兴奋性是正常的。

The basal ganglia play important roles in movement controls in the human brain. High frequency stimulation of the basal ganglia can alleviate motor symptoms of movement disorders, such as Parkinson's disease, essential tremor and general dystonia. However, the mechanism of action of deep brain stimulation (DBS) remains poorly understood. It is critical to determine which precise anatomical position is the clinically most effective site of DBS electrodes, Unfortunately, this information is difficult to obtain because of the limited resolution of imaging, individual variations in the position of deep brain structures and the spread of contacts to intended or unintended neural systems. Physiological studies can be of some help. In this study we recorded SEPs postoperatively with the contacts of DBS electrodes implanted permanently in the basal ganglia with monopolar and bipolar recordings from not only one location but also several locations. We analyzed the differences in the amplitude and phase of SEPs among the locations of DBS. We also studied SEPs in patients with a lesion throughout the sensory tract. These results lead us to know the relation between the effective position of DBS and SEP potentials in detail. This finding will provide much better information for DBS treatment.In addition, we also investigated the pathophysiological mechanisms of movement disorders using neurophysiological methods. We demonstrated that the excitability of the motor cortex was normal in patients with DTY5.