Waldau Ben, Clayton Daniel A, Gasperson Lynne B, Turner Dennis A
Department of Surgery, Division of Neurosurgery, Duke University Medical Center, Durham, NC 27710, USA.
Stereotact Funct Neurosurg. 2011;89(1):48-55. doi: 10.1159/000323340. Epub 2011 Jan 19.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) as treatment for Parkinson's disease has been in use for more than a decade, yet the immediate effect of stimulation upon movement parameters is not well characterized.
The goal of the current study is the identification of the best time point to test hand function after programming DBS devices.
Reaction time, movement time and velocity were measured at multiple time points with a movement-sensitive glove after the deep brain stimulator had been turned on or off, during 'off medication' conditions.
Velocity, movement time and reaction time worsened significantly in the first 20 min after the deep brain stimulator had been turned off. A 'plateau effect' after 20 min was not observed. Initiation of stimulation led to immediate significant increases in movement time and velocity and to a lesser degree a decrease in reaction time. Patients performed more inconsistently over time after onset of stimulation compared to stimulation withdrawal. Intraoperative testing showed an immediate improvement in velocity after placement of the STN deep brain stimulator.
Movement time and velocity already reach their peak changes within 20 min after the deep brain stimulator has been reprogrammed, and therefore, this time point may be used to test the maximal clinical effect of stimulation.
丘脑底核（STN）的深部脑刺激（DBS）作为帕金森病的治疗方法已应用了十多年，但刺激对运动参数的即时影响尚未得到很好的描述。
本研究的目的是确定在对DBS设备进行编程后测试手部功能的最佳时间点。
在“未服药”状态下，在深部脑刺激器开启或关闭后的多个时间点，使用运动敏感手套测量反应时间、运动时间和速度。
深部脑刺激器关闭后的前20分钟内，速度、运动时间和反应时间显著恶化。未观察到20分钟后的“平台效应”。刺激开始导致运动时间和速度立即显著增加，反应时间在较小程度上缩短。与刺激撤除相比，刺激开始后患者随时间推移表现得更不稳定。术中测试显示，在植入STN深部脑刺激器后速度立即改善。
在对深部脑刺激器重新编程后的20分钟内，运动时间和速度已达到其最大变化，因此，这个时间点可用于测试刺激的最大临床效果。
