帕金森病苍白球刺激术中药物减量的临床与影像相关性
Clinical and Imaging Correlates of Medication Reduction in Globus Pallidus Stimulation for Parkinson's Disease.
作者信息
Di Luca Daniel G, Ramirez-Gomez Carolina, Santyr Brendan, Fumagalli Marco, Germann Jürgen, Kalia Suneil K, Lozano Andres M, Fasano Alfonso
机构信息
Department of Neurology, Washington University, St. Louis, Missouri, USA.
Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada.
出版信息
Mov Disord Clin Pract. 2025 Mar 18;12(7):985-90. doi: 10.1002/mdc3.70042.
BACKGROUND
The magnitude and factors associated with levodopa equivalent daily dose (LEDD) reduction in deep brain stimulation (DBS) of the globus pallidus interna (GPi) for Parkinson's Disease (PD) remain unclear.
OBJECTIVE
To investigate LEDD reduction in GPi DBS and its correlation with anatomical/clinical characteristics.
METHODS
A consecutive cohort of 74 patients who had undergone GPi DBS was analyzed. Regression and probabilistic efficacy mapping were performed to evaluate factors predicting LEDD reduction.
RESULTS
32.4% of GPi individuals experienced significant LEDD reduction (>30%). Anteromedial GPi stimulation was associated with higher LEDD reduction.
CONCLUSION
Anteromedial stimulation of the GPi appears to be associated with medication reduction, challenging the idea that GPi DBS is ineffective at reducing LEDD. Further prospective study will be needed to validate these findings.
背景
帕金森病（PD）患者接受内侧苍白球（GPi）脑深部电刺激（DBS）时，左旋多巴等效日剂量（LEDD）降低的幅度及相关因素仍不清楚。
目的
研究GPi-DBS治疗中LEDD的降低情况及其与解剖学/临床特征的相关性。
方法
分析连续74例接受GPi-DBS治疗的患者队列。采用回归分析和概率疗效图谱评估预测LEDD降低的因素。
结果
32.4%的GPi患者LEDD显著降低（>30%）。GPi前内侧刺激与更高的LEDD降低相关。
结论
GPi的前内侧刺激似乎与药物减少有关，这对GPi-DBS在降低LEDD方面无效的观点提出了挑战。需要进一步的前瞻性研究来验证这些发现。
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