Lévesque M F, Taylor S, Rogers R, Le M T, Swope D
Cedars-Sinai Medical Center, Functional Neurosurgery Unit, Los Angeles, California 90048, USA.
Stereotact Funct Neurosurg. 1999;72(2-4):170-3. doi: 10.1159/000029721.
We wanted to evaluate chronic subthalamic nucleus (STN) stimulation as an alternative to pallidotomy for severe Parkinson's disease symptomatology.
Nine patients met clinical criteria for unilateral standard pallidotomy. All had severe medically refractory drug-induced dyskinesia and had reached maximal daily levodopa therapy. Pre- and postoperative videos, neuropsychometric testings and clinical stagings were administered. Three patients were selected to undergo stereotactic implantation of a deep brain stimulator (DBS) after Institutional Review Board approval and informed consent. These were performed using digitized microrecordings. The other group received unilateral pallidotomy.
At a mean follow-up of 6 months, our results support recent findings of significant major improvement in motor scores, activity of daily living and decrease in amount of daily levodopa intake by close to 50% after 3 months of stimulation.
Chronic stimulation of the STN appears to provide significant motor improvement in patients with severe Parkinson's disease and is more beneficial than pallidotomy.
我们旨在评估慢性丘脑底核（STN）刺激术作为严重帕金森病症状 pallidotomy 替代疗法的效果。
9 名患者符合单侧标准 pallidotomy 的临床标准。所有患者均有严重的药物难治性药物诱发异动症，且已达到左旋多巴每日最大治疗剂量。进行了术前和术后视频、神经心理测试及临床分期。经机构审查委员会批准并获得知情同意后，选择 3 名患者接受立体定向深部脑刺激器（DBS）植入。这些操作使用数字化微记录进行。另一组接受单侧 pallidotomy。
平均随访 6 个月时，我们的结果支持了近期的研究发现，即刺激 3 个月后，运动评分、日常生活活动能力有显著改善，每日左旋多巴摄入量减少近 50%。
慢性刺激 STN 似乎能使严重帕金森病患者的运动功能得到显著改善，且比 pallidotomy 更有益。
