帕金森病苍白球深部脑刺激引发的分离性震颤反应。
Dissociative Tremor Response with Pallidal Deep Brain Stimulation in Parkinson's Disease.
机构信息
Department of Neurology, University of Florida, Gainesville, FL, US.
Department of Neurology, Albany Medical Center, Albany, NY, US.
出版信息
Tremor Other Hyperkinet Mov (N Y). 2020 Dec 16;10:53. doi: 10.5334/tohm.568.
BACKGROUND
Pallidal and subthalamic targets are commonly used for deep brain stimulation in Parkinson's disease (PD), with similar efficacy for resting tremor control. However, neuromodulatory effects on kinetic and postural tremor in PD is less clear.
CASE REPORT
We present a 67-year-old PD patient with marked dissociative tremor response following pallidal neuromodulation. We observed excellent resting tremor suppression, but postural and kinetic tremors remained severe, requiring additional thalamic VIM stimulation for management.
DISCUSSION
Our findings illustrate the phenotypical differences in PD and differential response to diverse tremor characteristics with distinctive stimulation targets. Additional studies are necessary to understand these differences.
背景
在帕金森病（PD）的深部脑刺激中，苍白球和丘脑底核靶点通常被使用，它们对静止性震颤的控制效果相似。然而，对于 PD 中的运动性和姿势性震颤的神经调节作用尚不清楚。
病例报告
我们报告了一例 67 岁 PD 患者，在进行苍白球神经调节后出现明显的分离性震颤反应。我们观察到静止性震颤得到了极好的抑制，但姿势性和运动性震颤仍然严重，需要额外的丘脑腹中间核（VIM）刺激来进行管理。
讨论
我们的发现说明了 PD 的表型差异，以及对不同震颤特征的不同反应，不同的刺激靶点具有不同的反应。需要进一步的研究来理解这些差异。
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