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[深部脑刺激治疗运动障碍]

[Treatment of movement disorders with deep brain stimulation].

作者信息

Toft Mathias, Lilleeng Bård, Ramm-Pettersen Jon, Røste Geir Ketil, Pedersen Lena, Skogseid Inger Marie, Dietrichs Espen

机构信息

Nevrologisk avdeling, Nevroklinikken, Rikshospitalet, 0027 Oslo.

出版信息

Tidsskr Nor Laegeforen. 2008 Sep 11;128(17):1972-6.

Abstract

BACKGROUND

Deep brain stimulation is an established symptomatic treatment of movement disorders such as Parkinson's disease, tremor conditions and dystonia when medical treatment fails. We here present a review of indications and results for this treatment. We also present data om the activity related to patients with Parkinson's disease in a representative year and data on implantations performed Rikshospitalet University Hospital in the period 1999-2007.

MATERIAL AND METHODS

The manuscript is based on non-systematic searches in PubMed, clinical experience, and internal statistics on implantations and clinical visits carried out at our centre.

RESULTS AND INTERPRETATION

243 procedures were performed in our clinic in the period; 187 for Parkinson's disease, 37 for tremor and 19 for dystonia. The vast majority of patients have been implanted with bilateral electrodes, and the targets were the subthalamic nucleus, the thalamus and the internal segment of globus pallidus. Studies have demonstrated that deep brain stimulation is an effective treatment of selected patients with Parkinson's disease, tremors and primary dystonia. Many of these patients have no other efficient treatment options. Patients should be referred for preoperative assessment when symptoms of their movement disorder can no longer be treated sufficiently with medical therapies and when their quality of life is impaired. A broad and careful evaluation of patients' symptoms and findings is important for correct patient selection for this treatment.

摘要

背景

当药物治疗无效时,脑深部电刺激是帕金森病、震颤病症和肌张力障碍等运动障碍的一种既定的对症治疗方法。我们在此对这种治疗方法的适应症和结果进行综述。我们还展示了某代表性年份与帕金森病患者相关活动的数据,以及1999年至2007年期间在Rikshospitalet大学医院进行植入手术的数据。

材料与方法

本手稿基于在PubMed上的非系统检索、临床经验以及我们中心进行的植入手术和临床就诊的内部统计数据。

结果与解读

在此期间,我们诊所共进行了243例手术;其中187例针对帕金森病,37例针对震颤,19例针对肌张力障碍。绝大多数患者植入了双侧电极,靶点为丘脑底核、丘脑和苍白球内侧段。研究表明,脑深部电刺激是部分帕金森病、震颤和原发性肌张力障碍患者的有效治疗方法。这些患者中许多人没有其他有效的治疗选择。当运动障碍症状无法通过药物治疗充分控制且生活质量受损时,患者应接受术前评估。对患者症状和检查结果进行广泛而仔细的评估对于正确选择该治疗的患者至关重要。

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