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特发性震颤深部脑刺激引起的副作用的管理。

Management of essential tremor deep brain stimulation-induced side effects.

作者信息

Martinez-Nunez Alfonso Enrique, Sarmento Filipe P, Chandra Vyshak, Hess Christopher William, Hilliard Justin David, Okun Michael S, Wong Joshua K

机构信息

Norman Fixel Institute for Neurological Diseases, Gainesville, FL, United States.

Department of Neurology, University of Florida, Gainesville, FL, United States.

出版信息

Front Hum Neurosci. 2024 Feb 22;18:1353150. doi: 10.3389/fnhum.2024.1353150. eCollection 2024.

DOI:10.3389/fnhum.2024.1353150
PMID:38454907
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10918853/
Abstract

Deep brain stimulation (DBS) is an effective surgical therapy for carefully selected patients with medication refractory essential tremor (ET). The most popular anatomical targets for ET DBS are the ventral intermedius nucleus (VIM) of the thalamus, the caudal zona incerta (cZI) and the posterior subthalamic area (PSA). Despite extensive knowledge in DBS programming for tremor suppression, it is not uncommon to experience stimulation induced side effects related to DBS therapy. Dysarthria, dysphagia, ataxia, and gait impairment are common stimulation induced side effects from modulation of brain tissue that surround the target of interest. In this review, we explore current evidence about the etiology of stimulation induced side effects in ET DBS and provide several evidence-based strategies to troubleshoot, reprogram and retain tremor suppression.

摘要

对于精心挑选的药物难治性特发性震颤（ET）患者，深部脑刺激（DBS）是一种有效的外科治疗方法。ET-DBS最常用的解剖靶点是丘脑腹中间核（VIM）、尾侧未定带（cZI）和丘脑底后区（PSA）。尽管在DBS编程以抑制震颤方面已有广泛的知识，但在DBS治疗中出现与刺激相关的副作用并不罕见。构音障碍、吞咽困难、共济失调和步态障碍是刺激感兴趣靶点周围脑组织所常见的刺激诱发副作用。在本综述中，我们探讨了ET-DBS中刺激诱发副作用病因的现有证据，并提供了几种基于证据的故障排除、重新编程和维持震颤抑制的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b3f/10918853/8e1e1cd3abee/fnhum-18-1353150-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b3f/10918853/2ef34b9623af/fnhum-18-1353150-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b3f/10918853/6be403e343dc/fnhum-18-1353150-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b3f/10918853/8e1e1cd3abee/fnhum-18-1353150-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b3f/10918853/2ef34b9623af/fnhum-18-1353150-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b3f/10918853/6be403e343dc/fnhum-18-1353150-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b3f/10918853/8e1e1cd3abee/fnhum-18-1353150-g003.jpg

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Toxins (Basel). 2022 Nov 9;14(11):773. doi: 10.3390/toxins14110773.
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Diagnosis and Treatment of Essential Tremor.特发性震颤的诊断与治疗。
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Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor.短脉冲和定向丘脑深部脑刺激对帕金森病和特发性震颤有不同的影响。
Sci Rep. 2022 May 4;12(1):7251. doi: 10.1038/s41598-022-11291-9.
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