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The multifarious studies in the function and the dysfunction of human thalamocortical tract - Neurosurgical treatment in cases with intractable functional diseases of the brain (intractable pain and abnormal involuntary movement)

人类丘脑皮质束功能和功能障碍的多方面研究——脑部顽固性功能性疾病（顽固性疼痛和异常不自主运动）的神经外科治疗

基本信息

批准号：
03670671
负责人：
HIRATO Masafumi
金额：
$ 1.15万
依托单位：
Gunma University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1991
资助国家：
日本
起止时间：
1991 至 1992
项目状态：
已结题

项目摘要

(1) In the central pain patients with definite thalamic damage (superficial pain dominant), electrophysiological study of the thalamus using the depth microrecording showed that spontaneous neural activity(SNA) was markedly decreased in and around VIM (ventralis intermedius) nucleus. SNA in intralaminar nuclei (CL=centralis lateralis) was, however, higher than in VIM, especially in its dorsal part. Often, irregular burst discharge was encountered around the VC (ventralis caudalis) nucleus, especially in the dorsal part of the intralaminar nuclei along trajectories toward CL. In these cases, the greater the severity of superficial pain, the higher was the relative value of regional cerebral glucose metabolism as compared to oxygen metabolism in the cerebral cortex around central sulcus(Cxc) on the lesioned side. Also, regional oxygen extraction ratio increased in this area. Therefore, in central(thalamic) pain patients, the irritable state of thalamic intralaminar nuclei and the abnormal (increased) neural activity developed in the Cxc might play important roles for the genesis of central pain, especially superficial pain.(2) In rigid type Parkinson's disease(PD), the glucose metabolism was high in the lenticular nucleus but low in the Cxc. In contrast, chorea group showed low glucose metabolism in the lenticular nucleus but high in the motor and premotor cortex. The neural function of the basal ganglia and the cerebral cortex in rigid type PD are suggested to be totally different from that in hyperkinesia. In cases with hemitremor, the glucose metabolism was high in the Cxc as well as in the motor thalamus on the contralateral side. We postulated that those structures, as basal ganglia, thalamus and cerebral cortex, played important roles in maintaining and mediating abnormal involuntary movements.(3) Measurement of neurotransmitter using microdialysis was performed in the basal ganglia and the thalamus of normal or experimental tremor monkey.

(1)在具有明确丘脑损伤(浅表疼痛为主)的中枢性疼痛患者中，利用深度微记录对丘脑进行电生理学研究表明，VIM(腹中肌)核及其周围的自发神经活动(SNA)显着降低。然而，层内核（CL=外侧中央）的 SNA 高于 VIM，特别是在其背侧部分。通常，在 VC（尾腹肌）核周围会遇到不规则的爆发放电，特别是在沿着朝向 CL 的轨迹的板内核的背侧部分。在这些病例中，浅表疼痛越严重，与病变侧中央沟（Cxc）周围大脑皮层的氧代谢相比，局部脑葡萄糖代谢的相对值就越高。此外，该区域的局部氧气提取率有所增加。因此，在中枢性（丘脑）疼痛患者中，丘脑板内核团的激惹状态和Cxc异常（增强）的神经活动可能在中枢性疼痛，特别是浅表痛的发生中起重要作用。（2）僵硬型帕金森病（PD）中，豆状核糖代谢高，而Cxc糖代谢低。相比之下，舞蹈症组在豆状核中表现出低葡萄糖代谢，但在运动和前运动皮层中表现出高葡萄糖代谢。僵硬型PD的基底节和大脑皮层的神经功能被认为与运动机能亢进症完全不同。在偏侧震颤的病例中，Cxc 以及对侧运动丘脑的葡萄糖代谢较高。我们推测这些结构，如基底神经节、丘脑和大脑皮层，在维持和介导异常不自主运动中发挥着重要作用。(3)使用微透析对正常或实验性震颤猴的基底神经节和丘脑进行神经递质测量。