左侧苍白球内刺激治疗帕金森病的轴性运动障碍：一项随机试验。
Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: A Randomized Trial.
机构信息
The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Hospital Network and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Motor Physiology and Neuromodulation Program, Division of Movement Disorders, Department of Neurology and Center for Health and Technology, University of Rochester, Rochester, New York, USA.
出版信息
Mov Disord. 2022 May;37(5):1079-1087. doi: 10.1002/mds.28953. Epub 2022 Feb 13.
BACKGROUND
Patients with Parkinson's disease might develop treatment-resistant axial dysfunction after bilateral subthalamic stimulation.
OBJECTIVES
To study whether lateralized stimulation (unilateral 50% amplitude reduction) for ≥21 days results in ≥0.13 m/s faster gait velocity in the dopaminergic ON state in these patients, and its effects on motor and axial function, quantitative gait and speech measures, quality of life, and selected cognitive tasks.
METHODS
Randomized, double-blinded, double-crossover trial.
RESULTS
In 22 participants (51-79 years old, 15 women), there were no significant changes in gait velocity, quality of life, cognitive, and speech measures. Reducing left-sided amplitude resulted in a 2.5-point improvement in axial motor Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) (P = 0.005, uncorrected) and a 1.9-point improvement in the Freezing of Gait Questionnaire (P = 0.024, uncorrected).
CONCLUSIONS
Lateralized subthalamic stimulation does not result in meaningful improvement in gait velocity in patients with Parkinson's disease who develop treatment-resistant axial dysfunction after bilateral subthalamic stimulation. Left subthalamic overstimulation may contribute to axial deterioration in these patients. © 2022 International Parkinson and Movement Disorder Society.
背景
帕金森病患者在接受双侧丘脑底核刺激后可能会出现治疗抵抗性的轴性功能障碍。
目的
研究在这些患者中，是否进行 21 天以上的偏侧化刺激（单侧降低 50%的振幅），能否使多巴胺能 ON 状态下的步态速度提高≥0.13m/s，以及对运动和轴性功能、定量步态和言语测量、生活质量和选定认知任务的影响。
方法
随机、双盲、双交叉试验。
结果
在 22 名参与者（51-79 岁，15 名女性）中，步态速度、生活质量、认知和言语测量均无显著变化。降低左侧振幅可使轴向运动障碍统一帕金森病评定量表（MDS-UPDRS）的评分提高 2.5 分（P=0.005，未校正），冻结步态问卷（FOGQ）的评分提高 1.9 分（P=0.024，未校正）。
结论
在接受双侧丘脑底核刺激后出现治疗抵抗性轴性功能障碍的帕金森病患者中，偏侧化丘脑底核刺激不会导致步态速度有意义的改善。左侧丘脑底核过度刺激可能导致这些患者的轴性恶化。© 2022 国际帕金森病和运动障碍协会。
Zotero 插件