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美国神经科医生对深部脑刺激治疗帕金森病的态度调查。

Survey of U.S. neurologists' attitudes towards deep brain stimulation for Parkinson's disease.

机构信息

Department of Neurology, National Parkinson Foundation Center of Excellence, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.

出版信息

Neuromodulation. 2011 May-Jun;14(3):208-13; discussion 213. doi: 10.1111/j.1525-1403.2011.00350.x. Epub 2011 Apr 1.

Abstract

OBJECTIVES

Deep brain stimulation (DBS) for Parkinson's disease (PD) was approved by the Food and Drug Administration in 2002 and has demonstrated clinical benefit in advanced PD. Our aim was to assess attitudes of U.S. neurologists towards the role of DBS in management of advanced PD.

MATERIALS AND METHODS

We sent a 40-item Internet-based survey assessing opinions regarding the role of medical and surgical therapies in managing PD to 7722 neurologists in the American Medical Association Physician MasterFile data base.

RESULTS

The response rate was low (4.2%). In total, 78 of the 298 (26%) responders self-identified as movement disorders specialists. Specialists and non-specialists had differences on a number of medical strategies used to manage PD. There were no statistically significant differences in reasons for or against referring patients for DBS, except for the number of non-specialists who agreed with referring a patient who had a "poor or absent response to levodopa" (71% vs. 16%, p < 0.001). Both groups indicated a need for more information concerning appropriate indications for DBS, adverse effects of surgery, and postoperative programming.

CONCLUSIONS

Movement disorders specialists and non-specialists were in general agreement towards the beneficial role of DBS in management of advanced PD except for whether to refer patients with poor or absent response to levodopa.

摘要

目的

深部脑刺激(DBS)治疗帕金森病(PD)于 2002 年获得美国食品和药物管理局批准,并已在晚期 PD 中显示出临床获益。我们旨在评估美国神经科医生对 DBS 在晚期 PD 管理中作用的态度。

材料和方法

我们通过美国医学协会医师主文件数据库向 7722 名神经科医生发送了一项 40 项的基于互联网的调查,评估了关于医学和手术治疗在 PD 管理中的作用的意见。

结果

应答率较低(4.2%)。共有 298 名应答者中的 78 名(26%)自我认定为运动障碍专家。专家和非专家在用于管理 PD 的许多医疗策略上存在差异。对于是否将患者转介进行 DBS 的原因或反对意见,除了有多少非专家同意将“对左旋多巴反应不佳或无反应”的患者转介(71%比 16%,p < 0.001)外,没有统计学上的显著差异。两组均表示需要更多有关 DBS 适当适应症、手术不良反应和术后编程的信息。

结论

运动障碍专家和非专家总体上对 DBS 在晚期 PD 管理中的有益作用达成共识,除了是否将对左旋多巴反应不佳或无反应的患者转介这一点。

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