Cersosimo Maria G, Raina Gabriela B, Benarroch Eduardo E, Piedimonte Fabián, Alemán Gabriela González, Micheli Federico E
Parkinson Disease and Movement Disorders Unit, Hospital de Clínicas, University of Buenos Aires, Argentina.
Mov Disord. 2009 Jul 30;24(10):1488-93. doi: 10.1002/mds.22641.
To determine whether the immediate response to electrode implantation (micro lesion effect, MLE) in the internal segment of the globus pallidus (GPi) predicts symptom improvement with deep brain stimulation (DBS) at 6 months in patients with Parkinson's disease (PD) or generalized dystonia. Electrode implantation in the subthalamic nucleus (STN) prior to electrical stimulation has been reported to predict a beneficial effect of DBS in patients with PD, but whether this is also the case for the GPi in either PD or dystonia patients has not been established. We studied 20 patients (11 with PD and 9 with dystonia) who underwent electrode implantation in the GPi. Effects were assessed using standardized scales after 24 hours, weekly for 3 weeks prior to starting DBS, and after 6 months of DBS. 10 of 11 PD and 8 of 9 dystonia cases who benefited from electrode implantation also showed improvement in all motor and disability scores after 6 months of DBS of the GPi. One dystonia patient who did not show MLE benefited from DBS. The presence of MLE after electrode implantation in the GPi may help predict motor benefit from DBS in PD and generalized dystonia patients.
为了确定帕金森病（PD）或全身性肌张力障碍患者中，苍白球内侧部（GPi）电极植入后的即时反应（微损伤效应，MLE）是否能预测6个月深部脑刺激（DBS）后的症状改善情况。据报道，电刺激前在丘脑底核（STN）植入电极可预测DBS对PD患者的有益效果，但在PD或肌张力障碍患者中，GPi是否也是如此尚未明确。我们研究了20例在GPi植入电极的患者（11例PD患者和9例肌张力障碍患者）。在开始DBS前24小时、开始前3周每周以及DBS 6个月后，使用标准化量表评估效果。11例PD患者中有10例以及9例肌张力障碍患者中有8例从电极植入中获益，在GPi进行DBS 6个月后，所有运动和残疾评分也有所改善。1例未表现出MLE的肌张力障碍患者从DBS中获益。GPi电极植入后出现MLE可能有助于预测PD和全身性肌张力障碍患者从DBS中获得的运动益处。
