J Neurosurg. 2018 Mar;128(3):897-902. doi: 10.3171/2016.12.JNS16383. Epub 2017 May 26.
OBJECTIVE Subthalamic nucleus deep brain stimulation has been shown to be effective in reducing symptoms of primary Meige syndrome. However, assessments of its efficacy and safety have been limited to several case reports and small studies. METHODS The authors performed a retrospective study to assess the efficacy and safety of bilateral subthalamic nucleus stimulation in 15 patients with primary Meige syndrome who responded poorly to medical treatments or botulinum toxin injections. Using the movement and disability subscores of the Burke-Fahn-Marsden Dystonia Rating Scale, the authors evaluated the severity of patients' dystonia and related before surgery and at final follow-up during neurostimulation. The movement scale was assessed based on preoperative and postoperative video documentation by an independent rater who was unaware of each patient's neurostimulation status. Quality of life was assessed with the Medical Outcomes Study 36-Item Short-Form General Health Survey. RESULTS The dystonia movement subscores in 14 consecutive patients improved from 19.3 ± 7.6 (mean ± standard deviation) before surgery to 5.5 ± 4.5 at final follow-up (28.5 ± 16.5 months), with a mean improvement of 74% (p < 0.05). The disability subscore improved from 15.6 ± 4.9 before surgery to 6.1 ± 3.5 at final follow-up (p < 0.05). In addition, the postoperative SF-36 scores increased markedly over those at baseline. The authors also found that bilateral stimulation of the subthalamic nucleus immediately improved patient symptoms after stimulation and required lower stimulation parameters than those needed for pallidal deep brain stimulation for primary Meige syndrome. Four adverse events occurred in 3 patients; all of these events resolved without permanent sequelae. CONCLUSIONS These findings provide further evidence to support the long-term efficacy and safety of subthalamic nucleus stimulation as an alternative treatment for patients with medically intractable Meige syndrome.
研究表明，丘脑底核深部脑刺激对于减轻原发性 Meige 综合征的症状是有效的。然而，对其疗效和安全性的评估仅限于少数病例报告和小型研究。
作者对 15 例对药物治疗或肉毒杆菌毒素注射反应不佳的原发性 Meige 综合征患者进行了双侧丘脑底核刺激的回顾性研究。作者使用 Burke-Fahn-Marsden 肌张力障碍评定量表的运动和残疾分项评分，评估患者在接受神经刺激治疗前后的肌张力障碍严重程度和相关情况。运动量表是根据独立评分者术前和术后的视频记录进行评估的，评分者不知道每位患者的神经刺激状态。生活质量使用医疗结局研究 36 项简明健康调查量表进行评估。
14 例连续患者的肌张力障碍运动分项评分从术前的 19.3 ± 7.6（平均值 ± 标准差）改善到最终随访时的 5.5 ± 4.5（28.5 ± 16.5 个月），平均改善率为 74%（p < 0.05）。残疾分项评分从术前的 15.6 ± 4.9 改善到最终随访时的 6.1 ± 3.5（p < 0.05）。此外，术后 SF-36 评分显著高于基线水平。作者还发现，双侧丘脑底核刺激可立即改善患者的症状，且所需的刺激参数低于治疗原发性 Meige 综合征的苍白球深部脑刺激。3 例患者发生 4 例不良事件；所有这些事件均无永久性后遗症。
这些发现为丘脑底核刺激作为治疗药物难治性 Meige 综合征患者的替代疗法的长期疗效和安全性提供了进一步的证据。
