Objective To explore the feasibility of subthalamic nuclei (STN) targeting by magnetic resonance imaging (MRI) and intraoperative microelectrode recording before deep brain stimulation (DBS) in patients with Parkinson's disease and dystonia.Methods We selected 202 patients (382 sides) undergoing STN-DBS for Parkinson's and dystonia.STN sites targeted by MRI were testified by intraoperative microelectrode recording after opening cranium before DBS.Results ① STN targeted by MRI were clearly manifested in 288 of 382 sides, were ordinarily manifested in 72 sides and blurred in 22 sides.② The STN signals harvested in all 382 sides.The number of trajectories required to obtain sufficient STN activity was one in 339 sides, two in 43 sides.The STN signals were typical in 356 in 382 sides (93.1%) and untypical in 26 sides (6.9%).The mean STN length was (5.9±1.1) mm.③ 341 sides (94.7%) received typical STN signals in 360 satisfactory STN-targeting sides (clearly and ordinarily), as 15 sides (68.2%) received typical STN signals in 22 unsatisfactory STN-targeting sides before DBS.Conclusion MRI and intraoperative microelectrode recording can target subthalamic nuclei (STN) accurately before DBS in patients with Parkinson's disease and dystonia.%目的 探讨帕金森及肌张力障碍患者丘脑底核(STN)脑深部电刺激术(DBS)前用MRI和电生理刺激确定治疗靶点的可行性.方法 选择202例(共382侧)接受STN-DBS治疗的帕金森及肌张力障碍患者,术前在MRI上确定STN核团位置,作为治疗靶点,STN-DBS术前开颅后行电生理检测STN电信号,明确靶点定位是否准确. 结果 ①术前MRI上STN核团定位清晰288侧、尚可72侧、不清22侧.②382侧开颅后电生理检测记录到STN电生理信号,339侧首次穿刺即记录到STN信号,43侧更换靶点后再次穿刺记录到STN信号,其中356侧记录到典型STN电信号,26侧STN电信号不典型.STN信号长度(5.9±1.1)mm.③术前MRI上STN核团定位满意(清晰或尚可的360侧中,341侧(94.7%)术前电生理检测记录到典型STN电信号;术前STN核团定位不清的22侧中术中15侧(68.2%)术前电生理检测探及典型STN信号.结论 对于帕金森及肌张力障碍患者,术前MRI扫描联合电生理检测可精确定位STN-DBS术的治疗靶点.
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