Li Jiping, Mei Shanshan, Zhang Xiaohua, Wang Yunpeng, Jia Xiaofei, Liu Jinlong, Xu Erhe, Mao Wei, Zhang Yuqing
Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Front Neurosci. 2022 Aug 1;16:929273. doi: 10.3389/fnins.2022.929273. eCollection 2022.
Multiple system atrophy with predominant parkinsonism (MSA-P) is a highly incapacitating disease with a short life expectancy and symptomatic therapy is still limited. In this report, we presented the case of a 65-year-old woman with a 3-year history of severe rigidity, bradykinesia, and gait dysfunction alongside severe freezing of gait diagnosed with MSA-P. She underwent combined therapy of bilateral subthalamic nucleus deep brain stimulation (DBS) and low-thoracic spinal cord stimulation (SCS). The double-blind evaluation of the Movement Disorder Society Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III and 7-m Timed Up and Go at follow-ups showed her cardinal parkinsonian symptoms benefit significantly from DBS stimulation, while the improvement of SCS was mainly embodied in lower-limb symptoms. The combined stimulation achieved a better improvement of motor function than either DBS or SCS stimulation alone. Most notably, the improvement of lower-limb symptoms was significantly enhanced by the combined stimulation.
多系统萎缩伴帕金森综合征（MSA-P）是一种致残性很高的疾病，预期寿命短，且症状治疗仍然有限。在本报告中，我们介绍了一名65岁女性的病例，她有3年严重僵硬、运动迟缓、步态功能障碍病史，同时伴有严重的步态冻结，被诊断为MSA-P。她接受了双侧丘脑底核深部脑刺激（DBS）和胸段低位脊髓刺激（SCS）的联合治疗。在随访中，对运动障碍协会赞助的统一帕金森病评定量表第三部分和7米定时起立行走测试的双盲评估显示，她的主要帕金森症状因DBS刺激而显著改善，而SCS的改善主要体现在下肢症状上。联合刺激比单独的DBS或SCS刺激在运动功能改善方面取得了更好的效果。最值得注意的是，联合刺激显著增强了下肢症状的改善。
