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聚焦超声丘脑切开术治疗特发性震颤:一项针对中国人的2年疗效研究。

Focused Ultrasound Thalamotomy for the Treatment of Essential Tremor: A 2-Year Outcome Study of Chinese People.

作者信息

Wu Peihan, Lin Wei, Li Kun Hong, Lai Hui-Chin, Lee Ming-Tsung, Tsai Kevin Wen-Kai, Chiu Pai-Yi, Chang Wei-Chieh, Wei Cheng-Yu, Taira Takaomi

机构信息

Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan.

MR-Guided Focused Ultrasound Center, Chang Bing Show Chwan Memorial Hospital, Changhua County, Taiwan.

出版信息

Front Aging Neurosci. 2021 Jul 14;13:697029. doi: 10.3389/fnagi.2021.697029. eCollection 2021.

Abstract

Essential tremor (ET) is a common movement disorder among elderly individuals worldwide and is occasionally associated with a high risk for mild cognitive impairment and dementia. This retrospective study aimed to determine the clinical outcome of unilateral magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy in Chinese patients with ET. In total, 31 male and 17 female patients with drug-refractory ET were enrolled in this research study from January 2017 to September 2019. The severity of tremor and disability were assessed using the Clinical Rating Scale for Tremor (CRST) within a 2-year follow-up period. The mean age of the participants was 59.14 ± 13.5 years. The mean skull density ratio (SDR) was 0.5 ± 0.1. The mean highest temperature was 57.0 ± 2.4°C. The mean number of sonications was 10.0 ± 2.6. The average maximum energy was 19,710.5 ± 8,624.9 J. The total CRST scores and sub-scores after MRgFUS thalamotomy significantly reduced during each follow-up ( < 0.001). All but four (8.3%) of the patients had reversible adverse events (AEs) after the procedure. MRgFUS had sustained clinical efficacy 2 years after treatment for intractable ET. Only few patients presented with thalamotomy-related AEs including numbness, weakness, and ataxia for an extended period. Most Chinese patients were treated safely and effectively despite their low SDR.

摘要

特发性震颤(ET)是全球老年人群中常见的运动障碍,偶尔与轻度认知障碍和痴呆的高风险相关。这项回顾性研究旨在确定中国特发性震颤患者单侧磁共振引导聚焦超声(MRgFUS)丘脑切开术的临床结果。2017年1月至2019年9月,共有31例男性和17例女性药物难治性特发性震颤患者纳入本研究。在2年的随访期内,使用震颤临床评分量表(CRST)评估震颤严重程度和残疾情况。参与者的平均年龄为59.14±13.5岁。平均颅骨密度比(SDR)为0.5±0.1。平均最高温度为57.0±2.4°C。平均超声次数为10.0±2.6次。平均最大能量为19710.5±8624.9焦耳。MRgFUS丘脑切开术后每次随访时,CRST总分及各分项得分均显著降低(<0.001)。除4例(8.3%)患者外,所有患者术后均出现可逆性不良事件(AE)。MRgFUS治疗难治性特发性震颤2年后具有持续的临床疗效。只有少数患者长期出现与丘脑切开术相关的不良事件,包括麻木、无力和共济失调。尽管大多数中国患者的SDR较低,但治疗安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d6b/8317688/885b164412f9/fnagi-13-697029-g0001.jpg

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