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

基底神经节在人脑运动控制中起着重要作用。高频刺激基底神经节可以缓解运动障碍的运动症状，如帕金森病、特发性震颤和全身性肌张力障碍。然而，深部脑刺激（DBS）的作用机制尚不清楚。确定哪个精确的解剖位置是DBS电极在临床上最有效的部位是至关重要的，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到预期或非预期神经系统的扩散，很难获得这些信息。生理学研究可以提供一些帮助。在这项研究中，我们用基底节区永久植入的DBS电极记录了手术后的sep，并从一个位置和多个位置记录了单极和双极。我们分析了脑起搏器不同部位的sep振幅和相位的差异。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了DBS有效位置与SEP电位之间的关系。这一发现将为DBS治疗提供更好的信息。此外，我们还利用神经生理学方法探讨了运动障碍的病理生理机制。我们证明DTY5患者的运动皮质兴奋性是正常的。

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.