Neurological Surgery 脳神経外科49巻4号

2021年07月発行

特集 定位・機能神経外科の基礎と臨床 Ⅰ　定位・機能神経外科に必須な基礎知識

定位的脳手術における微小電極記録

著者： 岩室宏一¹

所属機関： ¹順天堂大学医学部脳神経外科

ページ範囲：P.737 - P.745

Point
・淡蒼球内節（GPi）は高頻度で持続発火する神経活動を特徴とし，後腹側領域では感覚運動関連応答が記録できる．
・視床下核（STN）には不規則な発火を特徴とする神経細胞が密に存在し，背外側領域では感覚運動関連応答が記録できる．
・視床中間腹側核（Vim核）の外側領域では振戦に同期する神経活動を高率に認め，感覚運動関連応答を有する．
・GPi，STN，Vim核の感覚運動領域にはそれぞれ身体部位局在がある．

参考文献

1）Cooper IS：Involuntary Movement Disorders. Hoeber, New York, 1969

2）Spiegel EA, et al：Stereotaxic apparatus for operations on human brain. Science 106：349-350, 1947

3）Narabayashi H, Okuma T：Procaine-oil blocking of the globus pallidus for the treatment of rigidity and tremor of parkinsonism. Proc Jpn Acad 29：134-137, 1953

4）Hassler R, Riechert T：Clinical effects produced by stimulation of different thalamic nuclei in human. Electroenceph Clin Neurophysiol 6：518-524, 1954

5）Wetzel N, Snider RS：Neurophysiological correlates in human stereotaxis. Q Bull Northwest Univ Med Sch 32：386-392, 1958

6）Benabid AL, et al：Combined（thalamotomy and stimulation）stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol 50：344-346, 1987

7）Pollak P, et al：Effects of the stimulation of the subthalamic nucleus in Parkinson disease. Rev Neurol（Paris）149：175-176, 1993

8）Kühn AA, et al：Pathological synchronisation in the subthalamic nucleus of patients with Parkinson's disease relates to both bradykinesia and rigidity. Exp Neurol 215：380-387, 2009

9）Buzsáki G, et al：The origin of extracellular fields and currents-EEG, ECoG, LFP and spikes. Nat Rev Neurosci 13：407-420, 2012

10）Laitinen LV, et al：Leksell's posteroventral pallidotomy in the treatment of Parkinson's disease. J Neurosurg 76：53-61, 1992

11）Wilson CJ：Basal ganglia. Shepherd GM（ed）：The Synaptic Organization of the Brain, 4th ed. Oxford University Press, New York, 1997, pp. 329-375

12）Hutchison WD, et al：Microelectrode recordings in movement disorder surgery. Lozano AM（ed）：Movement Disorder Surgery. Karger, Basel, 2000, pp. 103-117

13）Vitek JL, et al：Microelectrode-guided pallidotomy：technical approach and its application in medically intractable Parkinson's disease. J Neurosurg 88：1027-1043, 1998

14）Iwamuro H, et al：Information processing from the motor cortices to the subthalamic nucleus and globus pallidus and their somatotopic organizations revealed electrophysiologically in monkeys. Eur J Neurosci 46：2684-2701, 2017

15）岩室宏一，他：パーキンソン病患者のSTNおよびGPiにおける運動関連細胞のreceptive fieldの変化についての検討．機能脳神外 45：138-143, 2006

16）Vitek JL, et al：Microelectrode-guided pallidotomy for medically intractable Parkinson's disease. Obeso JA, et al（eds）：The Basal Ganglia and New Surgical Approaches for Parkinson's Disease. Lippincott-Raven, Philadelphia, 1997, pp. 183-198

17）Hutchison WD, et al：Neurophysiological identification of the subthalamic nucleus in surgery for Parkinson's disease. Ann Neurol 44：622-628, 1998

18）DeLong MR, et al：Relations between movement and single cell discharge in the substantia nigra of the behaving monkey. J Neurosci 8：1599-1606, 1983

19）Hirato M, et al：Superselective thalamotomy in the most lateral part of the ventralis intermedius nucleus for controlling essential and parkinsonian tremor. World Neurosurg 109：e630-e641, 2017

20）Raeva S：Localization in human thalamus of units triggered during ‘verbal commands,’ voluntary movements and tremor. Electroencephalogr Clin Neurophysiol 63：160-173, 1986

21）Vitek JL, et al：Physiologic properties and somatotopic organization of the primate motor thalamus. J Neurophysiol 71：1498-1513, 1994

22）Ohye C, et al：Further physiological observations on the ventralis intermedius neurons in the human thalamus. J Neurophysiol 61：488-500, 1989

23）Takahashi A, et al：Effect of electrical stimulation of the thalamic Vim nucleus on hand tremor during stereotactic thalamotomy. Electroencephalogr Clin Neurophysiol 109：376-384, 1998

24）Vitek JL, et al：Microstimulation of primate motor thalamus：somatotopic organization and differential distribution of evoked motor responses among subnuclei. J Neurophysiol 75：2486-2495, 1996

25）Ohye C：The thalamus. Paxinos G（ed）：The Human Nervous System. Academic Press, California, 1990, pp. 439-468

26）Jones EG, Friedman DP：Projection pattern of functional components of thalamic ventrobasal complex on monkey somatosensory cortex. J Neurophysiol 48：512-544, 1982