Dynamic studies on the human thalamocortical relation involved in the intractactable functional disorders of the brain

(1)丘脑感觉核轻度毁损的中枢性疼痛患者，电生理研究表明，感觉(主要是动觉)对外周自然刺激的感受野不同于丘脑Vim核的标准地形图。在这个核中有时可以识别出多重或会聚的反应。丘脑感觉核团可见不规则的爆发式放电。在明确丘脑损害的患者中，CVD病变周围丘脑感觉核团常可见不规则的爆发式放电。在本组中，这些核团的活动减少和异常的爆发式放电与中央沟(运动、运动前区)附近的皮质活动的变化有关。局部脑葡萄糖代谢(RCMRGlu)和rCMRGlu与氧代谢的比值在这些皮质区增加。抑制这些异常的神经元活性…对改善中枢性疼痛具有重要意义在丘脑感觉核团的CVD病变内及周围有更多的空洞。(2)在强直型和多巴诱发运动障碍(DID)型帕金森病(PD)患者中，注射L-多巴后出现DID时，豆状核糖代谢降低，额叶皮质糖代谢增加。使用rCBF的功能图研究显示，这些变化发生在额叶的运动前或前额叶区域。电生理研究表明，苍白球内侧段(GP)有高频、波幅较高的自发神经元活动。在偏血型帕金森病患者中，电生理检查一般显示，在生理确认的丘脑VIM中可记录到与周围性震颤时间锁定的节律性爆发放电。PET检查显示震颤对侧初级皮质感觉运动区rCMRGlu呈点状增高区，rCBF呈类似椭圆形增高区。RCBF增加的区域与对指顺序运动时rCBF图像的增加区域相似。反之，手部手法减震会导致该吻区局部脑血流量下降。(3)对正常或实验性震颤猴的基底节区和丘脑进行微透析神经递质测定。较少

(1) In the central pain patients with mild destruction of the thalamic sensory nuclei, electrophysiological study showed that the receptive field of sensory (mainly kinesthetic) responses to peripheral natural stimulation was different from standard thalamic topography in the VIM nucleus. Multiple or convergent responses were sometimes recognized in this nucleus. Irregular burst discharges were often encountered in the thalamic sensory nuclei. In those with definite thalamic damage, irregular burst discharges were often detected around CVD lesion in the thalamic sensory nuclei. Decreased activity with abnormal burst discharges in these nuclei was associated with changes of cortical activity adjacent to the central sulcus (motor, premotor area) in this group. Regional cerebral glucose metabolism (rCMRGlu) and relative ratio of rCMRGlu to oxygen metabolism increased on these cortical areas. It was important for ameliorating the central pain to inhibit these various abnormal neuronal acti … More vities occurred in and around the CVD lesion in the thalamic sensory nuclei. Gamma knife thalamotomy resulted in encouraging outcomes.(2) In rigid type and dopa-induced dyskinesia (DID) type Parkinson's disease (PD), when DID occurred after administration of L-Dopa, the glucose metabolism decreased in the lenticular nucleus but increased in the frontal cortex. Functional mapping study using rCBF revealed that these changes occurred within the premotor or prefrontal area in the frontal lobe. Electrophysiological study showed high frequency and amplitude spontaneous neuronal acitivities occurred in the medial segment of the globus pallidus (GP). In cases with hemitremor type PD,electrophysiological study generally showed that rhythmic burst discharges, being time-locked with peripheral tremor, were recorded in the physiologically identified thalamic VIM.PET study revealed spot-shaped increased zone of rCMRGlu and similar oval-shaped increased zone of rCBF in the primary cortical sensori-motor area on the contralateral side of tremor. This increased zone of rCBF was similar with that of rCBF image during the sequential opposite finger movement. Conversely, reducing tremor by hand manipulation caused decrease of rCBF in this rostral area.(3) Measurement of neurotransmitter using microdialysis was performed in the basal ganglia and the thalamus with normal or experimental tremor monkey. Less