Neuronal Activity in the Subthalamic Nucleus in Parkinson’s Disease
*Correspondencia: Dr. Carlos Magariños-Ascone. Departamento de Investiga- ción. Neurología Experimental-2D. Hospital Ramón y Cajal. Ctra. Colmenar, km 9. E-28034 Madrid.
Fax: 34 91336 9016.
E-mail: carlos.magarinos@hrc.es
Introduction. The subthalamic nucleus has been demonstrated to be involved in Parkinson’s disease. Electrical stimulation of this nucleus at high frequency was proved to revert most symptoms and is used as the most advanced alternative therapy. The technique requires the recording of single cell activity as an important step in locating spatially the limits of the nucleus together with magnetic resonance imaging and ventriculography. Objectives. To study the electrophysiological properties of single cells in the subthalamus. This information is important to recognize the nucleus in the operating room so as to implant the definitive stimulating electrode. Patients and methods. Twelve patients with Parkinson’s disease were implanted with bilateral electrodes in the subthalamic nucleus. Several neurological tests were applied during one year to study the clinical results. Results. Single cell activity was recorded in both hemispheres. Three types of cells were recognized based on the mode of discharge: tonic, phasic and rhythmic. The track chosen to implant the definitive electrode was based on the higher number of cells recorded and on the response to tremor and passive or voluntary movements. The neurological tests applied demonstrated a diminution of the symptoms. Conclusion. The subthalamic nucleus plays an important role in handling motor and sensory information. Stimulation of the nucleus at high frequency reveals an amelioration of Parkinson’s symptoms during the one year period of study.
Objetivos Estudiar las propiedades electrofisiológicas de células individuales del subtálamo. Esta información es importante para reconocer el núcleo en el quirófano con el fin de implantar el electrodo definitivo.
Pacientes y métodos Se implantaron electrodos bilaterales en el núcleo subtalámico de 12 pacientes con enfermedad de Parkinson. Se aplicaron varias pruebas neurológicas para el estudio de los resultados clínicos durante un año.
Resultados Se registró actividad celular individual en ambos hemisferios. Se reconocieron tres tipos de células basándose en el modo de descarga: tónica, fásica y rítmica. El camino elegido para implantar el electrodo definitivo se basó en el número más alto de células registradas y en la respuesta al temblor y a los movimientos pasivos o voluntarios.
Conclusiones El núcleo subtalámico desempeña un importante papel en el manejo de la información sensorial y motora. La estimulación de alta frecuencia del núcleo reveló la disminución de los síntomas parkinsonianos durante el período de un año que duró el estudio.