| Background and objectiveThere are two major measures for treating advanced Parikinson’s disease(PD)nowadays especially for those who suffer from levodopa induced dysfunctionafter long-term levodopa consumption. One is deep brain stimulation (DBS), theother is subcutaneous infusion of apomorphine(APO). Comparing with these twomeasures, half of year follow-up result revealed that DBS is better than APO forPD, although the DBS group is at high risk for side-effects including surgicalrelated side-effects. Because PD is a chronic progressive disease, it is obviousthat half of year follow-up is too short and that the result is less convincing. Inanimal research, rotation induced by APO is widely used as a direct indexwhether the hemiparkinsonism model is successfully established. The response ofrotation to anti-parkinsonism treatment can also be an index whether thetreatment is useful or not. Whether DBS can reduce the number of rotationinduced by APO or not may give an answer from animal behavioral aspect to the question which measure is better for advanced PD. It is controversial whetherhigh frequency stimulation of subthalamus nucleus can reduce or reverse therotation induced by APO according to current research. This article is focusing onestablishing a DBS model of STN in monkeys with hemiparkinsonism accuratelyand individualized. Then, effect of high frequency stimulation of STN on rotationinduced by APO was evaluated.MethodMPTP was injected into the unilateral internal carotid in4rhesus macaquesunder DSA to establish hemiparkinsonism model, and the model was evaluatedby Kurlan Scale, apomorphine test and immunohistochemical staining of tyrosinehydroxylase (TH). Then, the STN target coordinate was reserved by3.0T MRIscan data input Leksell system. MER recorded electrical signal of bilateral STNand determined the target, the electrode was implanted and fixed according to thedata of MER. The electrode position was checked by MRI postoperatively. Then,the effects of STN-DBS and APO on motor function of the hemiparkinsonismmodel were evaluated by Kurlan Scale. The effects of different frequenciesstimulation of STN on rotation induced by APO in hemiparkinsoniams monkeyand the effects of APO on hemiparkinsonism monkey stimulated by differentfrequencies were also evaluated.ResultKurlan Scale score4weeks after MPTP injected was （20.5±1.91）. Thenumber of rotation induced by APO was （26.4±7.3）/min. The result of THstaining showed that dopaminergic nigral neurons reduced by more than91.3%inthe substantia nigra and corpora striata of lesioned side compared with theunlesioned side by semiquantitative analysis. MER recorded the electricaldischarge of bilateral STN, and the rate of electrical discharge at the side of MPTP injection （(50.65±9.36)Hz） was obviously higher than that at the otherside（(22.55±6.51)Hz）. The reserved coordinate by MRI was revised by MER,and the ends of electrodes were situated in the STN by MRI postoperatively.Kurlan Scale scores in control group, APO injection group,130Hz stimulationgroup,30Hz stimulation group were （23±2.16）（,11.5±1.29）（,10.5±1.29）,（23.5±1.73）respectively.130Hz stimulation reduced the number of rotationinduced by APO from（26.25±3.59）/min to （0.75±0.96）/min.30Hzstimulation did no effect on the number of rotation. APO had no effect on thehemiparkinsonism monkey stimulated by130Hz, which can induce rotation ofhemiparkinsonism monkey stimulated by30Hz.ConclusionDBS model of STN in monkeys with hemiparkinsonism can be accuratelyindividualized established by MER combined with MRI. STN-HFS can reversethe rotation induced by APO while low frequency stimulation had no effect onthe rotation. APO had no effect on the hemiparkinsonism monkey stimulated byhigh frequency, which can induced out rotation of hemiparkinsonism monkeystimulated by low frequency. STN-HFS is better than APO for advanced PDaccording to the animal behavior. There may be a common basis betweenSTN-HFS and APO on Parkinson’s disease. |
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