丘脑底核深部脑刺激改善晚期帕金森病症状：单机构经验
Improvement of Advanced Parkinson's Disease Manifestations with Deep Brain Stimulation of the Subthalamic Nucleus: A Single Institution Experience.
作者信息
Rabie Ahmed, Verhagen Metman Leo, Fakhry Mazen, Eassa Ayman Youssef Ezeldin, Fouad Wael, Shakal Ahmed, Slavin Konstantin V
机构信息
Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA.
Department of Neurosurgery, Alexandria University, Alexandria, Egypt.
出版信息
Brain Sci. 2016 Dec 13;6(4):58. doi: 10.3390/brainsci6040058.
We present our experience at the University of Illinois at Chicago (UIC) in deep brain stimulation (DBS) of the subthalamic nucleus (STN), describing our surgical technique, and reporting our clinical results, and morbidities. Twenty patients with advanced Parkinson's disease (PD) who underwent bilateral STN-DBS were studied. Patients were assessed preoperatively and followed up for one year using the Unified Parkinson's Disease Rating Scale (UPDRS) in "on" and "off" medication and "on" and "off" stimulation conditions. At one-year follow-up, we calculated significant improvement in all the motor aspects of PD (UPDRS III) and in activities of daily living (UPDRS II) in the "off" medication state. The "off" medication UPDRS improved by 49.3%, tremors improved by 81.6%, rigidity improved by 50.0%, and bradykinesia improved by 39.3%. The "off" medication UPDRS II scores improved by 73.8%. The Levodopa equivalent daily dose was reduced by 54.1%. The UPDRS IVa score (dyskinesia) was reduced by 65.1%. The UPDRS IVb score (motor fluctuation) was reduced by 48.6%. Deep brain stimulation of the STN improves the cardinal motor manifestations of the idiopathic PD. It also improves activities of daily living, and reduces medication-induced complications.
我们介绍了伊利诺伊大学芝加哥分校（UIC）在丘脑底核（STN）深部脑刺激（DBS）方面的经验，描述了我们的手术技术，报告了临床结果及并发症情况。对20例接受双侧STN-DBS的晚期帕金森病（PD）患者进行了研究。术前对患者进行评估，并在“开”药与“关”药以及“开”刺激与“关”刺激状态下，使用统一帕金森病评定量表（UPDRS）进行为期一年的随访。在一年的随访中，我们计算得出在“关”药状态下，PD的所有运动方面（UPDRS III）以及日常生活活动（UPDRS II）均有显著改善。“关”药时UPDRS改善了49.3%，震颤改善了81.6%，强直改善了50.0%，运动迟缓改善了39.3%。“关”药时UPDRS II评分改善了73.8%。左旋多巴等效日剂量减少了54.1%。UPDRS IVa评分（异动症）降低了65.1%。UPDRS IVb评分（运动波动）降低了48.6%。STN深部脑刺激改善了特发性PD的主要运动表现。它还改善了日常生活活动，并减少了药物引起的并发症。
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