Fasano Alfonso, Piano Carla, De Simone Celestino, Cioni Beatrice, Di Giuda Daniela, Zinno Massimiliano, Daniele Antonio, Meglio Mario, Giordano Alessandro, Bentivoglio Anna Rita
Istituto di Neurologia, Università Cattolica del Sacro Cuore, Roma, Italia.
Mov Disord. 2008 Oct 15;23(13):1916-9. doi: 10.1002/mds.21977.
In a primate model of Parkinson's disease (PD), the benefit of extradural motor cortex stimulation (EMCS) was associated with high-frequency stimulation (130 Hz), whereas no significant motor improvement was achieved at 10 Hz or intermediate frequencies of stimulation. We report the case of a 72-year-old female patient affected by severe PD who underwent bilateral EMCS. In baseline med-off condition the patient was unable to arise from a chair and to stand without assistance. Stimulation at 3 and 60 Hz failed to provide any improvement of symptoms, whereas, when stimulating at 130 Hz, axial akinesia and walking improved consistently: the patient, in med-off condition, was able to arise from chair and to walk without assistance. The patient underwent two brain 99mTc- Ethylcysteinate Dimer-SPECT studies: semiquantitative and Statistical Parametric Mapping revealed that the regional cerebral perfusion was significantly increased in the supplementary motor area during stimulation at 130 Hz. After five months, the benefit of EMCS gradually disappeared.
在帕金森病（PD）的灵长类动物模型中，硬膜外运动皮层刺激（EMCS）的益处与高频刺激（130Hz）相关，而在10Hz或中间频率刺激时未实现显著的运动改善。我们报告了一例72岁患有严重PD的女性患者接受双侧EMCS的病例。在基线停药状态下，患者无法在无辅助的情况下从椅子上起身和站立。3Hz和60Hz刺激未能改善任何症状，而在130Hz刺激时，轴性运动不能和步行持续改善：在停药状态下，患者能够在无辅助的情况下从椅子上起身和行走。该患者接受了两次脑部99mTc-乙半胱氨酸二聚体单光子发射计算机断层扫描（SPECT）研究：半定量和统计参数映射显示，在130Hz刺激期间，辅助运动区的局部脑灌注显著增加。五个月后，EMCS的益处逐渐消失。
