Velez-Lago Frances M, Oyama Genko, Foote Kelly D, Hwynn Nelson, Zeilman Pamela, Jacobson Charles, Wu Samuel, Okun Michael S
Departments of Neurology and Neurosurgery, University of Florida, Center for Movement Disorders & Neurorestoration, Gainesville, Florida, United States of America.
Tremor Other Hyperkinet Mov (N Y). 2012;2. doi: 10.7916/D85X27PH. Epub 2012 Jan 30.
It has been observed that low-frequency stimulation (LFS) may be effective for dystonia, and the use of LFS may alleviate the need for frequent battery changes in a subset of patients. The aim of this study was to analyze LFS as a strategy to treat deep brain stimulation (DBS) patients with various dystonias.
Subjects had to receive a minimum of 6 months of clinical follow-up at the University of Florida, and were required to have a minimum of 3 months on a LFS trial. Twenty-seven dystonia DBS patients were retrospectively analyzed from the UF-INFORM database.
Thirteen subjects met inclusion criteria. Of the 13 subjects, all had bilateral internal pallidum (GPi) DBS, and five (38.5%) remained with at least one side on LFS settings at their last follow up (average follow up 24 months, range 6-46 months). Within the first 6 months, six (46%) subjects remained on LFS and seven (54%) were changed to high-frequency stimulation (HFS). Those who remained on LFS settings at 6 months were characterized by shorter disease durations than those on HFS settings. There were no significant differences in dystonia severity (Unified Dystonia Rating Scale and Burke-Fahn-Marsden Dystonia Rating Scale) at baseline between the two settings. The estimated battery life for LFS (79.9±30.5) was significantly longer than for HFS settings (32.2±13.1, p<0.001).
LFS was ultimately chosen for 38.5% of all subjects. Although this study failed to yield solid predictive features, subjects on LFS tended to have shorter disease durations.
据观察，低频刺激（LFS）可能对肌张力障碍有效，并且在一部分患者中使用LFS可能减少频繁更换电池的需求。本研究的目的是分析LFS作为治疗各种肌张力障碍的深部脑刺激（DBS）患者的一种策略。
受试者必须在佛罗里达大学接受至少6个月的临床随访，并且在LFS试验中至少进行3个月。从UF-INFORM数据库中对27例肌张力障碍DBS患者进行回顾性分析。
13名受试者符合纳入标准。在这13名受试者中，均接受双侧苍白球内侧核（GPi）DBS，5名（38.5%）在最后一次随访时至少一侧仍采用LFS设置（平均随访24个月，范围6 - 46个月）。在最初6个月内，6名（46%）受试者仍采用LFS，7名（54%）改为高频刺激（HFS）。6个月时仍采用LFS设置的受试者的疾病持续时间比采用HFS设置的受试者短。两种设置在基线时的肌张力障碍严重程度（统一肌张力障碍评定量表和伯克-法恩-马斯登肌张力障碍评定量表）无显著差异。LFS的估计电池寿命（79.9±30.5）明显长于HFS设置（32.2±13.1，p<0.001）。
最终38.5%的受试者选择了LFS。尽管本研究未能得出可靠的预测特征，但采用LFS的受试者往往疾病持续时间较短。
