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目的通过单光子放射计算机断层扫描(SPECT)功能显像研究探讨丘脑底核脑深部电刺激(STN DBS)对纹状体多巴胺系统代谢的影响。方法对2只偏侧帕金森病(PD)模型猴及4例临床PD患者在施行单侧STN DBS手术前后给予SPECT检查,测定纹状体区域多巴胺转运体(DAT)及多巴胺D2受体(D2R)含量变化。结果STN DBS电刺激后2只偏侧PD模型猴及3例疗效较好的PD患者纹状体区DAT含量明显增加,2只PD模型猴D2R含量逐渐下降,4例患者D2R检测与术前无统计学意义。结论STN DBS可以明显改善PD症状,SPECT检查显示刺激侧纹状体区DAT含量升高,提示STN DBS可能改善了刺激侧纹状体区多巴胺的代谢,这可能是STN DBS的作用机制之一。
Objective To investigate the effect of subthalamic nucleus deep brain stimulation (STN DBS) on the metabolism of striatum dopamine system by single photon emission computed tomography (SPECT) imaging. Methods SPECT was performed on 2 PD patients and 4 PD patients before and after unilateral STN DBS. The levels of dopamine transporter (DAT) and dopamine D2 receptor (D2R ) Content changes. Results The DAT content in striatum of 2 monophasic PD model monkeys and 3 patients with PD with good therapeutic effect was significantly increased after STN DBS stimulation. The D2R content of 2 PD model monkeys decreased gradually. The D2R detection in 4 patients was not associated with preoperative Statistical significance. Conclusions STN DBS can significantly improve the symptoms of PD. SPECT examination showed that the DAT level in the striatum is increased, suggesting that STN DBS may improve the metabolism of dopamine in the lateral striatum, which may be one of the mechanisms of STN DBS.