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通过将 DBS 从 STN 的前内侧引导至中脑腹侧被盖区来解决持续抗 OCD 疗效的运动障碍 - 病例报告。

Resolving dyskinesias at sustained anti-OCD efficacy by steering of DBS away from the anteromedial STN to the mesencephalic ventral tegmentum - case report.

机构信息

Department of Stereotactic and Functional Neurosurgery, Medical Center of Freiburg University, Freiburg, Germany.

Medical Faculty of Freiburg University, Freiburg, Germany.

出版信息

Acta Neurochir (Wien). 2022 Sep;164(9):2303-2307. doi: 10.1007/s00701-022-05206-w. Epub 2022 May 2.

DOI:10.1007/s00701-022-05206-w
PMID:35499574
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9427876/
Abstract

Here we describe therapeutic results in a female patient who underwent bilateral slMFB DBS for OCD. During a 35-month long course of stimulation, she suffered from stimulation-induced dyskinesia of her right leg which we interpreted as co-stimulation of the adjacent anteromedial subthalamic nucleus (amSTN). After reprogramming to steer the stimulation away from the amSTN medial into the direction of the mesencephalic ventral tegmentum (MVT which contains the ventral tegmental area, VTA), the dyskinesias disappeared. Remarkably, anti-OCD efficacy in the presented patient was preserved and achieved with a bilateral stimulation which by our imaging study fully avoided the amSTN.

摘要

在这里，我们描述了一位女性患者接受双侧苍白球内侧部脑深部电刺激（slMFB DBS）治疗强迫症的治疗结果。在长达 35 个月的刺激过程中，她的右腿出现了由刺激引起的运动障碍，我们将其解释为相邻的内前丘脑底核（amSTN）的共刺激。在重新编程以将刺激从 amSTN 内侧引导到中脑腹侧被盖区（MVT，包含腹侧被盖区，VTA）的方向后，运动障碍消失了。值得注意的是，该患者的抗强迫症疗效得以保留，并且采用了双侧刺激，我们的影像学研究表明，这种刺激完全避开了 amSTN。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb88/9427876/8c02f9c5c366/701_2022_5206_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb88/9427876/4abfd38ed2cd/701_2022_5206_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb88/9427876/8c02f9c5c366/701_2022_5206_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb88/9427876/4abfd38ed2cd/701_2022_5206_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb88/9427876/8c02f9c5c366/701_2022_5206_Fig2_HTML.jpg

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Directional electrodes in deep brain stimulation: Results of a survey by the European Association of Neurosurgical Societies (EANS).深部脑刺激中的定向电极：欧洲神经外科学会（EANS）的一项调查结果
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Tremor Other Hyperkinet Mov (N Y). 2023 Aug 28;13:28. doi: 10.5334/tohm.780. eCollection 2023.