Kim Han-Joon, Lee Jee-Young, Kim Ji-Young, Kim Dong Gyu, Paek Sun Ha, Jeon Beom S
Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
Clin Neurol Neurosurg. 2008 Apr;110(4):328-32. doi: 10.1016/j.clineuro.2007.11.007. Epub 2008 Mar 4.
The goal of this study was to assess the effect of bilateral subthalamic deep brain stimulation (STN DBS) on levodopa-induced diphasic dyskinesia in patients with Parkinson disease (PD).
Six PD patients with diphasic dyskinesia were included in this study. Prior to surgery, the duration and severity of dyskinesia were determined in each patient, along with the Unified Parkinson Disease Rating Scale score and Hoehn and Yahr stage. Bilateral STN electrode implantation was performed during a single operation.
The median duration of the follow-up period was 21.5 months (range 14-24 months). STN DBS had a beneficial effect on diphasic dyskinesia in all patients. At the last follow-up, 3 patients had no dyskinesia and 1 had only a small amount of peak-dose dyskinesia. One patient showed a reduction in the duration of diphasic dyskinesia, despite a lack of reduction in the total duration of dyskinesia. In the last patient, although the total duration of dyskinesia increased, the pattern of dyskinesia changed from severe painful disabling dyskinesia to the less severe peak-dose type of dyskinesia. There were no intraoperative or postoperative surgical complications.
Bilateral STN DBS is good at reducing diphasic dyskinesia, and it can be a good therapeutic option for patients with diphasic dyskinesia.
本研究的目的是评估双侧丘脑底核深部脑刺激（STN DBS）对帕金森病（PD）患者左旋多巴诱导的双相异动症的影响。
本研究纳入了6例患有双相异动症的PD患者。手术前，确定每位患者异动症的持续时间和严重程度，以及统一帕金森病评定量表评分和霍恩和雅尔分期。在单次手术中进行双侧STN电极植入。
随访期的中位数为21.5个月（范围14 - 24个月）。STN DBS对所有患者的双相异动症均有有益影响。在最后一次随访时，3例患者无异动症，1例仅出现少量峰剂量异动症。1例患者双相异动症的持续时间缩短，尽管异动症的总持续时间没有缩短。在最后1例患者中，尽管异动症的总持续时间增加，但异动症的模式从严重的疼痛性致残性异动症转变为不太严重的峰剂量型异动症。术中及术后均无手术并发症。
双侧STN DBS善于减少双相异动症，对于患有双相异动症的患者而言，它可能是一种良好的治疗选择。
