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帕金森病患者不同疾病进展率在随访一年中接受丘脑底核脑深部电刺激术的结果

Outcomes of STN-DBS in PD Patients With Different Rates of Disease Progression Over One Year of Follow-Up.

作者信息

Qi Renli, Geng Xin, Huang Baihui, Chen Ye, Jiang Honggao, Zou Yanghong, Wang Wei, Li Yubin, Li Yushan, Yin Lei, Liu Anxiong, Yang Xuelan, Li Jinghui, Yu Hualin

机构信息

Second Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, Kunming, China.

出版信息

Front Neurol. 2020 Jul 24;11:600. doi: 10.3389/fneur.2020.00600. eCollection 2020.

Abstract

Parkinson's disease (PD) is a progressive neurodegenerative disorder, and the rate of progression is different across individuals. Subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to produce long-term symptom improvement in PD. In this retrospective study, we wanted to explore the effects of bilateral STN-DBS in PD patients with different rates of disease progression. Forty patients with PD were included. An index of progression rate was calculated by the ratio of the Unified Parkinson Disease Rating Scale, part III (UPDRS-III), score in the off-medication condition at baseline and disease duration. The patients were divided into fast-, medium-, and slow-progression groups by this index. The outcome measurements at the 1st, 6th, and 12th months after surgery were the changes in UPDRS-III scores in the off-medication/on-stimulation condition compared with the baseline. We found the following. (1). Motor functions in the different PD progression groups were improved by bilateral STN-DBS treatment at 1 year of follow-up. (2). However, compared to the slow- and medium-progression groups, the fast-progression group had less improvement at the 6th- and 12th-month follow-up. The results indicated that bilateral STN-DBS can improve motor functions of Parkinson's patients over the 1-year follow-up. Moreover, the outcomes in the slow- and medium-progression patients were better than those with fast-progression rates.

摘要

帕金森病(PD)是一种进行性神经退行性疾病,其进展速度因人而异。丘脑底核深部脑刺激(STN-DBS)已被证明可使帕金森病患者的症状得到长期改善。在这项回顾性研究中,我们想探讨双侧STN-DBS对疾病进展速度不同的帕金森病患者的影响。纳入了40例帕金森病患者。通过统一帕金森病评定量表第三部分(UPDRS-III)在基线时非服药状态下的得分与病程的比值计算进展速度指数。根据该指数将患者分为快速进展组、中等进展组和缓慢进展组。术后第1、6和12个月的疗效指标是与基线相比,非服药/刺激状态下UPDRS-III得分的变化。我们发现如下情况。(1)。在随访1年时,双侧STN-DBS治疗可改善不同帕金森病进展组的运动功能。(2)。然而,与缓慢进展组和中等进展组相比,快速进展组在第6个月和第12个月随访时改善较少。结果表明,双侧STN-DBS在1年的随访中可改善帕金森病患者的运动功能。此外,缓慢进展和中等进展患者的疗效优于快速进展患者。

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