Aubignat M, Lefranc M, Tir M, Krystkowiak P
CHU Amiens-Picardie, service de neurologie, Amiens, France.
CHU Amiens-Picardie, service de neurochirurgie, Amiens, France.
Rev Neurol (Paris). 2020 Dec;176(10):770-779. doi: 10.1016/j.neurol.2020.02.009. Epub 2020 Apr 15.
Deep brain stimulation (DBS) is a well-established treatment for Parkinson's disease (PD) leading to a significant reduction in motor and non-motor symptoms. Numerous factors contribute to positive outcomes for DBS including careful patient selection, lead placement and effective programming. Only DBS programming can be modified after patient implantation, therefore DBS programming plays a crucial role in improving clinical outcomes. In this paper, we review the literature to present current issues and perspectives for DBS programming in PD. Only a few algorithms proposed by experts for the initial programming and management of some adverse effects are available. No guidelines are available for programming sessions and medical treatment management during DBS follow-up. Moreover, emergence of increasingly complex lead designs makes programming more and more complex. Fortunately, in the last few years numerous techniques have emerged for optimization of DBS programming in PD.
脑深部电刺激术（DBS）是一种成熟的帕金森病（PD）治疗方法，可显著减轻运动和非运动症状。多种因素有助于DBS取得积极效果，包括仔细的患者选择、电极植入位置和有效的程控。患者植入后只有DBS程控可以修改，因此DBS程控在改善临床疗效方面起着关键作用。在本文中，我们回顾文献以阐述PD中DBS程控的当前问题和观点。目前仅有少数专家提出的用于初始程控和某些不良反应管理的算法。在DBS随访期间，尚无关于程控环节和药物治疗管理的指南。此外，日益复杂的电极设计使得程控越来越复杂。幸运的是，在过去几年中出现了许多用于优化PD中DBS程控的技术。
