Merola Aristide, Fasano Alfonso, Hassan Anhar, Ostrem Jill L, Contarino Maria Fiorella, Lyons Mark, Krauss Joachim K, Wolf Marc E, Klassen Bryan T, van Rootselaar Anne-Fleur, Regidor Ignacio, Duker Andrew P, Ondo William, Guridi Jorge, Volkmann Jens, Wagle Shukla Aparna, Mandybur George T, Okun Michael S, Witt Karsten, Starr Philip A, Deuschl Günther, Espay Alberto J
Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA.
Division of Neurology, Movement disorders center, University of Toronto Canada Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
Mov Disord. 2017 Aug;32(8):1240-1244. doi: 10.1002/mds.27082. Epub 2017 Jun 20.
We report the accumulated experience with ventral intermediate nucleus deep brain stimulation for medically refractory orthostatic tremor.
Data from 17 patients were reviewed, comparing presurgical, short-term (0-48 months), and long-term (≥48 months) follow-up. The primary end point was the composite activities of daily living/instrumental activities of daily living score. Secondary end points included latency of symptoms on standing and treatment-related complications.
There was a 21.6% improvement (P = 0.004) in the composite activities of daily living/instrumental activities of daily living score, which gradually attenuated (12.5%) in the subgroup of patients with an additional long-term follow-up (8 of 17). The latency of symptoms on standing significantly improved, both in the short-term (P = 0.001) and in the long-term (P = 0.018). Three patients obtained no/minimal benefit from the procedure.
Deep brain stimulation of the ventral intermediate nucleus was, in general, safe and well tolerated, yielding sustained benefit in selected patients with medically refractory orthostatic tremor. © 2017 International Parkinson and Movement Disorder Society.
我们报告了腹中间核脑深部电刺激治疗药物难治性直立性震颤的累积经验。
回顾了17例患者的数据，比较术前、短期（0 - 48个月）和长期（≥48个月）随访情况。主要终点是日常生活综合活动/日常生活工具性活动评分。次要终点包括站立时症状的潜伏期和治疗相关并发症。
日常生活综合活动/日常生活工具性活动评分有21.6%的改善（P = 0.004），在进行额外长期随访的患者亚组（17例中的8例）中改善逐渐减弱（12.5%）。站立时症状的潜伏期在短期（P = 0.001）和长期（P = 0.018）均有显著改善。3例患者从该手术中未获得益处或获益极小。
一般来说，腹中间核脑深部电刺激是安全的且耐受性良好，对部分药物难治性直立性震颤患者有持续的益处。© 2017国际帕金森病和运动障碍协会。
