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运动障碍协会统一帕金森病评定量表在评估丘脑底核深部脑刺激效果中的应用

Utility of movement disorder society-unified Parkinson's disease rating scale for evaluating effect of subthalamic nucleus deep brain stimulation.

作者信息

Yamamoto Tatsuya, Yamanaka Yoshitaka, Hirano Shigeki, Higuchi Yoshinori, Kuwabara Satoshi

机构信息

Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Department of Rehabilitation Science, Chiba Prefectural University of Health Sciences, Chiba, Japan.

出版信息

Front Neurol. 2023 Jan 6;13:1042033. doi: 10.3389/fneur.2022.1042033. eCollection 2022.

Abstract

BACKGROUND

The Movement Disorders Society (MDS)-Unified Parkinson's Disease Rating Scale (UPDRS) is increasingly used to assess motor dysfunction before and after subthalamic nucleus deep brain stimulation (STN-DBS).

OBJECTIVES

We, therefore, investigated whether the MDS-UPDRS can detect longitudinal changes in motor function after STN-DBS in the same way as UPDRS.

METHODS

We examined 21 patients with Parkinson's disease (PD) (mean age 59.2 ± 10.6 years, mean disease duration 12.0 ± 3.0 years) who underwent STN-DBS and whose motor functions were assessed by the UPDRS and MDS-UPDRS before, 3 months after, and 1 year after STN-DBS. We then evaluated the consistency between the scores of Parts II and III of the UPDRS and MDS-UPDRS during the off phase using Lin's concordance coefficient (LCC) and a Bland-Altman plot.

RESULTS

The scores of Parts II and III of both the UPDRS and MDS-UPDRS were significantly decreased 3 months and 1 year after STN-DBS during the off phase. Scores of the UPDRS and MDS-UPDRS showed significant positive correlations before and after STN-DBS. We calculated estimated MDS-UPDRS scores from the UPDRS scores using a regression line and calculated the LCC between the MDS-UPDRS and the estimated MDS-UPDRS scores. The LCC value was 0.59-0.91, which suggests a relatively high consistency between the UPDRS and MDS-UPDRS. The Bland-Altman plot showed that differences between both scores were basically within ±1.96 standard deviations of the difference.

CONCLUSION

The present preliminary study indicated that the utility of the MDS-UPDRS in evaluating motor function before and after STN-DBS demonstrates its potential equivalency to the UPDRS.

摘要

背景

运动障碍协会(MDS)统一帕金森病评定量表(UPDRS)越来越多地用于评估丘脑底核深部脑刺激(STN-DBS)前后的运动功能障碍。

目的

因此,我们研究了MDS-UPDRS能否与UPDRS一样检测STN-DBS后运动功能的纵向变化。

方法

我们检查了21例帕金森病(PD)患者(平均年龄59.2±10.6岁,平均病程12.0±3.0年),这些患者接受了STN-DBS,并在STN-DBS前、后3个月和1年后通过UPDRS和MDS-UPDRS评估了他们的运动功能。然后,我们使用林氏一致性系数(LCC)和布兰德-奥特曼图评估了关期UPDRS和MDS-UPDRS第二部分和第三部分得分之间的一致性。

结果

STN-DBS后3个月和1年关期时,UPDRS和MDS-UPDRS的第二部分和第三部分得分均显著降低。STN-DBS前后,UPDRS和MDS-UPDRS得分呈显著正相关。我们使用回归线从UPDRS得分计算估计的MDS-UPDRS得分,并计算MDS-UPDRS与估计的MDS-UPDRS得分之间的LCC。LCC值为0.59-0.91,这表明UPDRS和MDS-UPDRS之间具有较高的一致性。布兰德-奥特曼图显示,两个得分之间的差异基本在差异的±1.96标准差范围内。

结论

本初步研究表明,MDS-UPDRS在评估STN-DBS前后运动功能方面的效用证明了其与UPDRS的潜在等效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac2b/9852822/9819278754b6/fneur-13-1042033-g0001.jpg

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