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特发性节段性肌张力障碍长期苍白球刺激后运动亢进的发生

Development of Hyperkinesias after Long-term Pallidal Stimulation for Idiopathic Segmental Dystonia.

作者信息

Wloch Andreas, Blahak Christian, Abdallat Mahmoud, Heissler Hans E, Wolf Marc E, Krauss Joachim K

机构信息

Department of Neurosurgery, Hannover Medical School, Hannover, Germany.

Department of Neurology, Klinikum Mannheim, University of Heidelberg, Mannheim, Germany.

出版信息

Tremor Other Hyperkinet Mov (N Y). 2017 Sep 19;7:480. doi: 10.7916/D8V416KN. eCollection 2017.

DOI:10.7916/D8V416KN
PMID:28975047
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5623755/
Abstract

BACKGROUND

Chronic deep brain stimulation (DBS) of the globus pallidus internus (GPi) has become an established treatment for dystonia. While bradykinetic symptoms may occur on chronic stimulation, the appearance of hyperkinetic movements has not been well characterized.

CASE REPORT

We report on the development of hyperkinesias after more than 10 years of GPi DBS.

DISCUSSION

Hyperkinesias may evolve upon long-term GPi DBS in dystonia. This might be related to a combined effect consisting of a reduced threshold for effective GPi stimulation for dystonia and spread of current to the globus pallidus externus.

摘要

背景

内侧苍白球(GPi)的慢性深部脑刺激(DBS)已成为治疗肌张力障碍的既定方法。虽然慢性刺激时可能会出现运动迟缓症状,但运动亢进性运动的出现尚未得到充分描述。

病例报告

我们报告了在进行GPi DBS超过10年后出现运动亢进的情况。

讨论

肌张力障碍患者长期进行GPi DBS可能会出现运动亢进。这可能与以下综合效应有关:肌张力障碍有效GPi刺激的阈值降低,以及电流扩散至外侧苍白球。

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Development of Hyperkinesias after Long-term Pallidal Stimulation for Idiopathic Segmental Dystonia.特发性节段性肌张力障碍长期苍白球刺激后运动亢进的发生
Tremor Other Hyperkinet Mov (N Y). 2017 Sep 19;7:480. doi: 10.7916/D8V416KN. eCollection 2017.
2
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本文引用的文献

1
Movement disorders induced by deep brain stimulation.深部脑刺激诱发的运动障碍
Parkinsonism Relat Disord. 2016 Apr;25:1-9. doi: 10.1016/j.parkreldis.2016.01.014. Epub 2016 Jan 14.
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Persistent chorea in DYT6, due to anticholinergic therapy.
Parkinsonism Relat Disord. 2015 Oct;21(10):1282-3. doi: 10.1016/j.parkreldis.2015.07.024. Epub 2015 Aug 5.
3
Varying time-course of effects of high frequency stimulation of sub-regions of the globus pallidus in patients with parkinson's disease.帕金森病患者中高频刺激苍白球不同亚区域的效应的时间进程变化
Parkinsonism Relat Disord. 2015 Jun;21(6):597-602. doi: 10.1016/j.parkreldis.2015.03.019. Epub 2015 Mar 27.
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Pallidal neurostimulation in patients with medication-refractory cervical dystonia: a randomised, sham-controlled trial.药物难治性颈肌张力障碍患者的苍白球神经刺激:一项随机、假手术对照试验。
Lancet Neurol. 2014 Sep;13(9):875-84. doi: 10.1016/S1474-4422(14)70143-7. Epub 2014 Aug 7.
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Sustained relief of generalized dystonia despite prolonged interruption of deep brain stimulation.尽管长时间中断深部脑刺激,仍能持续缓解全身性肌张力障碍。
Mov Disord. 2013 Sep;28(10):1431-4. doi: 10.1002/mds.25353. Epub 2013 Feb 11.
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Pallidal deep brain stimulation in patients with primary generalised or segmental dystonia: 5-year follow-up of a randomised trial.苍白球深部脑刺激治疗原发性全身性或节段性肌张力障碍患者:一项随机试验的 5 年随访结果。
Lancet Neurol. 2012 Dec;11(12):1029-38. doi: 10.1016/S1474-4422(12)70257-0. Epub 2012 Nov 1.
7
The influence of deep brain stimulation intensity and duration on symptoms evolution in an OFF stimulation dystonia study.深部脑刺激强度和持续时间对 OFF 刺激性肌张力障碍研究中症状演变的影响。
Brain Stimul. 2013 Jul;6(4):500-5. doi: 10.1016/j.brs.2012.09.005. Epub 2012 Oct 8.
8
GPi-DBS may induce a hypokinetic gait disorder with freezing of gait in patients with dystonia.苍白球内侧核(GPi)-脑深部电刺激(DBS)可能会引起伴有冻结步态的运动徐缓型步态障碍,这种情况在肌张力障碍患者中较为常见。
Neurology. 2011 Aug 2;77(5):483-8. doi: 10.1212/WNL.0b013e318227b19e. Epub 2011 Jul 20.
9
Long-term clinical outcome in meige syndrome treated with internal pallidum deep brain stimulation.Meige 综合征行脑深部电刺激苍白球内侧部治疗的长期临床疗效。
Mov Disord. 2011 Mar;26(4):691-8. doi: 10.1002/mds.23549. Epub 2011 Feb 10.
10
Micrographia induced by pallidal DBS for segmental dystonia: a subtle sign of hypokinesia?苍白球 DBS 治疗节段性肌张力障碍引起的手微颤:运动减少的微妙迹象?
J Neural Transm (Vienna). 2011 Apr;118(4):549-53. doi: 10.1007/s00702-010-0544-y. Epub 2011 Jan 19.