Wan Xiaonan, Lin Zhengyu, Zeng Zhitong, Zhang Yingying, Duan Chengcheng, Zhang Chencheng, Li Dianyou
Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
Front Hum Neurosci. 2024 Feb 14;18:1296726. doi: 10.3389/fnhum.2024.1296726. eCollection 2024.
Patients suffering from refractory obsessive-compulsive disorder (OCD) who have undergone deep brain stimulation (DBS) surgery require repeated in-person programming visits. These sessions could be labor-intensive and may not always be feasible, particularly when in-person hospital visits are restricted. Telemedicine is emerging as a potential supplementary tool for post-operative care. However, its reliability and feasibility still require further validation due to the unconventional methods of interaction.
A study was conducted on three patients with refractory OCD who had undergone DBS. Most of their programming sessions were completed via a remote programming system. These patients were recruited and monitored for a year. Changes in their clinical symptoms were assessed using the Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II), the Hamilton Anxiety Scale-14 (HAMA), the Hamilton Depression Scale-17 (HAMD), and the Short Form 36 Health Survey Questionnaire (SF-36). The scores from these assessments were reported.
At the last follow-up, two out of three patients were identified as responders, with their Y-BOCS-II scores improving by more than 35% (P1: 51%, P3: 42%). These patients also experienced some mood benefits. All patients observed a decrease in travel expenses during the study period. No severe adverse events were reported throughout the study.
The group of patients showed improvement in their OCD symptoms within a 1-year follow-up period after DBS surgery, without compromising safety or benefits. This suggests that telemedicine could be a valuable supplementary tool when in-person visits are limited.
患有难治性强迫症(OCD)且接受过脑深部电刺激(DBS)手术的患者需要多次亲自到医院进行程控。这些环节可能耗费人力,而且并不总是可行,尤其是在限制亲自到医院就诊的情况下。远程医疗正成为术后护理的一种潜在辅助工具。然而,由于其非传统的互动方式,其可靠性和可行性仍需进一步验证。
对3例接受DBS手术的难治性OCD患者进行了一项研究。他们的大多数程控环节是通过远程程控系统完成的。招募这些患者并对其进行了为期一年的监测。使用耶鲁-布朗强迫症量表第二版(Y-BOCS-II)、汉密尔顿焦虑量表14项版(HAMA)、汉密尔顿抑郁量表17项版(HAMD)和简明健康调查36项问卷(SF-36)评估他们临床症状的变化。报告了这些评估的得分。
在最后一次随访时,3例患者中有2例被确定为有反应者,其Y-BOCS-II得分改善超过35%(P1:51%,P3:42%)。这些患者在情绪方面也有所获益。所有患者在研究期间的差旅费均有所减少。在整个研究过程中未报告严重不良事件。
该组患者在DBS手术后1年的随访期内OCD症状有所改善,且不影响安全性或获益。这表明在亲自就诊受限的情况下,远程医疗可能是一种有价值的辅助工具。