Wang Ning, Wu Yifeng, Yao Chen, Meng Dawei, Zhang Haoran, Cheng Qinxiu, Zhang Xiaodong, Shen Hailiang, Lu Yingqi, Wang Lin, Xu Jinping
Department of Neurosurgery, Aviation General Hospital, Beijing 100012, China.
Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.
Brain Commun. 2025 Feb 8;7(1):fcaf042. doi: 10.1093/braincomms/fcaf042. eCollection 2025.
The deep brain stimulation (DBS) in the subthalamic nucleus (STN) has attracted more attention for primary Meige syndrome due to easier target location and lower power consumption. However, potential and reliable preoperative predictors of longitudinal outcomes of STN-DBS to guide therapeutic decisions remain largely unexplored. Herein, we used preoperative structural MRI and Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) from 55 patients with primary Meige syndrome who finished STN-DBS after 5 years. They were further classified into response ( = 23) and super-response ( = 32) based on the improvement rates of BFMDRS. Voxel-based morphology, partial correlation analyses, receiver operating characteristic (ROC) analyses and support vector machine were performed. We identified that improved rates of BFMDRS were 63, 71.97, 76.64, 79.51, 81.02, 81.36, 81.16, 80.80 and 80.93% at 1, 3, 6, 12, 18, 24, 36, 48 and 60 months after STN-DBS, respectively, and remained steady across 1-5 years. Further voxel-based morphology analyses revealed significantly lower grey-matter volume in the right hippocampus, left putamen, right supramarginal gyrus and left superior frontal gyrus in response when compared with super-response. The grey-matter volumes in the left putamen, right supramarginal gyrus and left superior frontal gyrus were not only positively correlated with improvement rates of BFMDRS after STN-DBS for 5 years in the primary Meige syndrome, but also presented a reliable classification ability in distinguishing response and super-response (area under curve = 0.855). These results suggested that STN-DBS is an effective treatment for primary Meige syndrome, and preoperative grey-matter volume of putaminal-cortical circuits could be used as potential biomarkers to predict longitudinal outcomes.
由于丘脑底核（STN）深部脑刺激（DBS）靶点定位更容易且功耗更低，因此在原发性梅杰综合征中受到了更多关注。然而，STN-DBS纵向预后的潜在且可靠的术前预测指标以指导治疗决策在很大程度上仍未得到探索。在此，我们使用了55例原发性梅杰综合征患者术前的结构磁共振成像（MRI）和伯克-法恩-马斯登肌张力障碍评定量表（BFMDRS），这些患者在5年后完成了STN-DBS治疗。根据BFMDRS的改善率，他们被进一步分为有反应组（n = 23）和超反应组（n = 32）。进行了基于体素的形态学分析、偏相关分析、受试者工作特征（ROC）分析和支持向量机分析。我们发现，STN-DBS术后1、3、6、12、18、24、36、48和60个月时，BFMDRS的改善率分别为63%、71.97%、76.64%、79.51%、81.02%、81.36%、81.16%、80.80%和80.93%，并且在1至5年期间保持稳定。进一步的基于体素的形态学分析显示，与超反应组相比，有反应组右侧海马、左侧壳核、右侧缘上回和左侧额上回的灰质体积显著更低。左侧壳核、右侧缘上回和左侧额上回的灰质体积不仅与原发性梅杰综合征患者STN-DBS术后5年BFMDRS的改善率呈正相关，而且在区分有反应组和超反应组方面具有可靠的分类能力（曲线下面积 = 0.855）。这些结果表明，STN-DBS是原发性梅杰综合征的一种有效治疗方法，术前壳核-皮质环路的灰质体积可用作预测纵向预后的潜在生物标志物。
