帕金森病中分期单侧与双侧丘脑底核刺激器植入术

Staged unilateral versus bilateral subthalamic nucleus stimulator implantation in Parkinson disease.

作者信息

Samii Ali, Kelly Valerie E, Slimp Jefferson C, Shumway-Cook Anne, Goodkin Robert

机构信息

Department of Neurology, University of Washington, Seattle, Washington, USA.

Parkinson Disease Research Education and Clinical Center, Neurology Section, VA Puget Sound Health Care System, Seattle, Washington, USA.

出版信息

Mov Disord. 2007 Jul 30;22(10):1476-1481. doi: 10.1002/mds.21554.

DOI:10.1002/mds.21554

PMID:17523194

Abstract

In 17 consecutive patients with Parkinson disease (PD), bilateral subthalamic nucleus (STN) stimulators were implanted during staged surgeries. The Unified Parkinson Disease Rating Scale (UPDRS) and the Dyskinesia Disability Scale were completed both off and on medication prior to any surgery and also OFF and ON stimulation after each surgery. On-medication UPDRS activities of daily living (ADL) and motor examination scores changed little with unilateral or bilateral stimulation. Off-medication UPDRS motor examination scores improved to similar degrees after each staged STN electrode implantation. Most of the improvements in off-medication ADL scores, dyskinesia scores, complications of therapy, and medication dose reduction occurred after unilateral STN stimulation with smaller improvements after the second operation.

摘要

在17例帕金森病（PD）患者中，分期手术期间植入双侧丘脑底核（STN）刺激器。在任何手术前以及每次手术后刺激开启和关闭时，均使用帕金森病统一评分量表（UPDRS）和运动障碍残疾量表进行评估。服药状态下的UPDRS日常生活活动（ADL）和运动检查评分，在单侧或双侧刺激时变化不大。每次分期植入STN电极后，未服药状态下的UPDRS运动检查评分均有相似程度的改善。未服药状态下的ADL评分、运动障碍评分、治疗并发症及药物剂量减少等方面的改善，大多发生在单侧STN刺激后，第二次手术后改善较小。