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丘脑底核深部脑刺激对帕金森病出汗功能的影响。

Effects of subthalamic nucleus deep brain stimulation on sweating function in Parkinson's disease.

作者信息

Trachani Eftichia, Constantoyannis Constantine, Sirrou Vassiliki, Kefalopoulou Zinovia, Markaki Elli, Chroni Elisabeth

机构信息

Department of Neurology, School of Medicine, University of Patras, Rio-Partras 26504, Greece.

出版信息

Clin Neurol Neurosurg. 2010 Apr;112(3):213-7. doi: 10.1016/j.clineuro.2009.11.015. Epub 2009 Dec 22.

Abstract

PURPOSE

To assess the impact of subthalamic nucleus (STN) deep brain stimulation (DBS) on the sweating function in patients with advanced Parkinson's disease (PD).

METHODS

Nineteen patients with idiopathic PD (mean age+/-SD, 61.58+/-9.47) were examined immediately before and 6 months after DBS. Each examination session included registration of autonomic symptoms by means of a semi-structural questionnaire and recording of sympathetic skin response (SSR) from both palms and one sole. The neurophysiological measurements were compared to those of 19 matched for sex and age healthy controls.

RESULTS

Six months post-DBS motor improvement was amounted to 65.9% and the daily levodopa equivalent dose was decreased by 36.4%. Post-operatively, dyshidrosis manifestations were reduced by 66.7% (pre-DBS sudomotor dysfunction in 47.4% of patients and sudomotor fluctuation in 57.1% of the above patients). There were no significant differences in-between pre- and post-DBS results of SSR study. However, the number of patients with at least one abnormal SSR pre-operative was reduced from 6 to 3 post-operative. No correlation was found between this neurophysiological finding and the change of clinical symptoms of hyperhidrosis or the DBS motor improvement.

CONCLUSIONS

These results, although based on a small sample, suggest that STN DBS, in addition to the effect to the mobility, might also favorably regulate sweat in idiopathic PD.

摘要

目的

评估丘脑底核(STN)深部脑刺激(DBS)对晚期帕金森病(PD)患者出汗功能的影响。

方法

对19例特发性PD患者(平均年龄±标准差,61.58±9.47)在DBS术前及术后6个月进行检查。每次检查包括通过半结构化问卷记录自主神经症状,并记录双侧手掌和单足的交感神经皮肤反应(SSR)。将神经生理学测量结果与19名年龄和性别匹配的健康对照者的结果进行比较。

结果

DBS术后6个月运动改善率达65.9%,左旋多巴等效日剂量降低36.4%。术后,多汗症表现减少了66.7%(术前47.4%的患者存在出汗功能障碍,上述患者中有57.1%存在出汗功能波动)。SSR研究的术前和术后结果之间无显著差异。然而,术前至少有一项SSR异常的患者数量从6例减少到术后的3例。未发现这一神经生理学发现与多汗症临床症状变化或DBS运动改善之间存在相关性。

结论

这些结果虽然基于小样本,但表明STN DBS除了对运动功能有影响外,可能还对特发性PD患者的出汗有良好的调节作用。

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