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丘脑底核深部脑刺激治疗帕金森病患者不安腿综合征的最佳接触位置:33例患者的一年随访

Optimal Contact Position of Subthalamic Nucleus Deep Brain Stimulation for Reducing Restless Legs Syndrome in Parkinson's Disease Patients: One-Year Follow-Up with 33 Patients.

作者信息

Lei Hongbing, Yang Chunhui, Zhang Mingyang, Qiu Yiqing, Wang Jiali, Xu Jinyu, Hu Xiaowu, Wu Xi

机构信息

Department of Neurosurgery, the First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai 200433, China.

Department of Chemistry, University of Utah, 201 Presidents' Cir, Salt Lake City, UT 8412, USA.

出版信息

Brain Sci. 2022 Dec 1;12(12):1645. doi: 10.3390/brainsci12121645.

Abstract

Objectives: To determine the short- and medium-term therapeutic effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on restless legs syndrome (RLS) in patients with Parkinson’s disease (PD) and to study the optimal position of activated contacts for RLS symptoms. Methods: We preoperatively and postoperatively assessed PD Patients with RLS undergoing STN-DBS. Additionally, we recorded the stimulation parameters that induced RLS or relieved RLS symptoms during a follow-up. Finally, we reconstructed the activated contacts’ position that reduced or induced RLS symptoms. Results: 363 PD patients were enrolled. At the 1-year follow-up, we found that the IRLS sum significantly decreased in the RLS group (preoperative 18.758 ± 7.706, postoperative 8.121 ± 7.083, p < 0.05). The results of the CGI score, MOS sleep, and RLS QLQ all showed that the STN-DBS improved RLS symptoms after one year. Furthermore, the activated contacts that relieved RLS were mainly located in the central sensorimotor region of the STN. Activated contacts in the inferior sensorimotor part of the STN or in the substantia nigra might have induced RLS symptoms. Conclusions: STN-DBS improved RLS in patients with PD in one year, which reduced their sleep disorders and increased their quality of life. Furthermore, the central sensorimotor region part of the STN is the optimal stimulation site.

摘要

目的

确定丘脑底核(STN)深部脑刺激(DBS)对帕金森病(PD)患者不安腿综合征(RLS)的短期和中期治疗效果,并研究缓解RLS症状的最佳激活触点位置。方法:我们对接受STN-DBS的伴有RLS的PD患者进行术前和术后评估。此外,我们记录了随访期间诱发RLS或缓解RLS症状的刺激参数。最后,我们重建了减轻或诱发RLS症状的激活触点位置。结果:共纳入363例PD患者。在1年随访时,我们发现RLS组的国际不安腿综合征评分总和显著降低(术前18.758±7.706,术后8.121±7.083,p<0.05)。临床总体印象量表(CGI)评分、医学结局研究(MOS)睡眠量表和RLS生活质量问卷(RLS QLQ)的结果均显示,STN-DBS在1年后改善了RLS症状。此外,缓解RLS的激活触点主要位于STN的中央感觉运动区。STN下部感觉运动区或黑质中的激活触点可能会诱发RLS症状。结论:STN-DBS在1年内改善了PD患者的RLS,减少了他们的睡眠障碍,提高了他们的生活质量。此外,STN的中央感觉运动区是最佳刺激部位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfaa/9775276/d9ffce848343/brainsci-12-01645-g001.jpg

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