Steinhardt Julia, Zittel Simone, Tadic Vera, Tronnier Volker, Moll Christian, Bäumer Tobias, Münchau Alexander, Rasche Dirk, Brüggemann Norbert
Department of Neurology and Institute of Neurogenetics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Center of Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany.
Neurol Res Pract. 2024 May 23;6(1):28. doi: 10.1186/s42466-024-00316-5.
Pallidal deep brain stimulation (GPi-DBS) has been considered as an effective treatment option for medication-refractory Huntington's disease (HD).
To identify stimulation-dependent effects on motor symptoms and to determine if these alterations are associated with the local impact of DBS on different pallidal parcellations.
We prospectively evaluated the effects of bilateral GPi-DBS within one year in 5 HD patients. We evaluated the effects of GPi-DBS on choreatic symptoms and UHDRS. Electrode placement in the pallidum was localized, and the local impact of DBS was estimated.
The chorea subscore (p < 0.001) and UHDRS total motor score was significantly reduced postoperatively (p = 0.019). Pallidal DBS did not improve other motor symptoms. Activation of the lateral GPi/GPe was associated with improvement in choreatic symptoms (p = 0.048; r = 0.90).
Our findings indicate that stimulation of the lateral GPi has a stable effect on choreatic symptoms. The modulation of the electrical field is relevant for motor outcome.
苍白球深部脑刺激术（GPi-DBS）已被视为药物难治性亨廷顿舞蹈病（HD）的一种有效治疗选择。
确定对运动症状的刺激依赖性效应，并确定这些改变是否与DBS对不同苍白球分区的局部影响相关。
我们前瞻性评估了5例HD患者在1年内双侧GPi-DBS的效果。我们评估了GPi-DBS对舞蹈症状和统一亨廷顿舞蹈病评定量表（UHDRS）的影响。确定苍白球内电极的位置，并评估DBS的局部影响。
术后舞蹈症评分（p < 0.001）和UHDRS总运动评分显著降低（p = 0.019）。苍白球DBS未改善其他运动症状。外侧苍白球/苍白球腹外侧核（GPi/GPe）的激活与舞蹈症状改善相关（p = 0.048；r = 0.90）。
我们的研究结果表明，刺激外侧苍白球对舞蹈症状有稳定作用。电场调节与运动结果相关。
