苍白球和丘脑底核深部脑刺激治疗单侧肌张力障碍：前瞻性评估。
Pallidal and Thalamic Deep Brain Stimulation in the Treatment of Unilateral Dystonia: A Prospective Assessment.
机构信息
Neurosurgery Department, Hospital Angeles Clínica Londres, Mexico City, Mexico.
Neurology Department, Hospital Angeles Clínica Londres, Mexico City, Mexico.
出版信息
Mov Disord Clin Pract. 2024 Oct;11(10):1274-1280. doi: 10.1002/mdc3.14184. Epub 2024 Aug 2.
BACKGROUND
The complexities of unilateral dystonia have led to exploring simultaneous (dual) globus pallidus internus (GPi) and motor ventral thalamus (Vim/Vop) deep brain stimulation (DBS), yet detailed assessments are lacking.
OBJECTIVES
To assess the efficacy of GPi, Vim/Vop, and dual DBS in unilateral dystonia.
METHODS
Three patients with unilateral dystonia (two idiopathic, one acquired), implanted with two DBS electrodes targeting ipsilateral Vim/Vop and GPi, were included. Three stimulation modalities were assessed. First, one electrode was activated, then the other, and finally, both electrodes were activated simultaneously.
RESULTS
DBS yielded substantial symptomatic reductions in all three evaluated stimulation modalities. Patients exhibited varying responses regarding quality-of-life and depressive symptoms. Treatment satisfaction didn't align with clinical improvements, potentially affected by unrealistic expectations.
CONCLUSIONS
This study contributes critical insights into GPi, Vim/Vop and simultaneous stimulation for unilateral dystonia. The safety of the procedure underscores the promise of this approach.
背景
单侧肌张力障碍的复杂性促使人们探索同时（双）进行苍白球内侧（GPi）和运动腹侧丘脑（Vim/Vop）深部脑刺激（DBS），但缺乏详细评估。
目的
评估 GPi、Vim/Vop 和双 DBS 在单侧肌张力障碍中的疗效。
方法
纳入了 3 名单侧肌张力障碍患者（2 名特发性，1 名获得性），他们植入了 2 个针对同侧 Vim/Vop 和 GPi 的 DBS 电极。评估了三种刺激模式。首先，激活一个电极，然后激活另一个电极，最后同时激活两个电极。
结果
在所有三种评估的刺激模式中，DBS 都显著减轻了症状。患者在生活质量和抑郁症状方面表现出不同的反应。治疗满意度与临床改善不一致，可能受不切实际的期望影响。
结论
本研究为单侧肌张力障碍的 GPi、Vim/Vop 和同时刺激提供了重要的见解。该程序的安全性突显了这种方法的前景。
Zotero 插件