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脑白质疏松症不影响帕金森病患者深部脑刺激术后的运动结局。

Leukoaraiosis does not impact motor outcomes in Parkinson's patients post deep brain stimulation.

作者信息

Martin Heather, Ali Rushna, Sriram Ashok, Coleman Robert, Ruether Emily, Boyce Hayden, Maley Morgan L, Khan Muhib

机构信息

Michigan State University, United States.

Cornell University, United States.

出版信息

Clin Park Relat Disord. 2025 May 12;12:100348. doi: 10.1016/j.prdoa.2025.100348. eCollection 2025.

Abstract

OBJECTIVES

We sought to assess the impact of leukoaraiosis (LA) on motor outcomes in Parkinson disease (PD) patients undergoing DBS. We hypothesized that LA is associated with less improvement in motor function in PD patients post-DBS.

METHODS

We reviewed data of adult patients with PD treated with DBS in a single center between 2012 and 2021. Demographics, risk factors, medications, Hoehn and Yahr scale and Unified Parkinson's Disease Rating Scale (UPDRS) Motor Score before and after DBS and severity of LA were collected. Simple linear regression (SLR) was used to determine variables of interest to include in the multiple linear regression (MLR). MLR was used to determine independent predictors of motor outcomes (UPDRS) post-DBS including LA as a continuous and dichotomized variable of interest.

RESULTS

A total of 90 patients were included in the analysis. Mean age was 65.7 years (±9.7), primarily male (69 %) with a high incidence of young onset PD (29 %), treated with carbidopa/levodopa combination (98 %) and with moderate severity of disease (Hoehn and Yahr Stage 2.0 [2.0, 2.5]). Moderate to severe leukoaraiosis was noted in 26 (32.5 %) patients. SLR revealed age, diabetes and disease severity as predictors of post-DBS motor UPDRS. In adjusted analysis, LA was not an independent predictor of motor outcomes post-DBS either as continuous (β = 0.20, p = 0.77) or dichotomized (β = -0.64; p = 0.77) variable.

CONCLUSION

In conclusion, our data suggests that motor outcomes in Parkinson's disease patients undergoing deep brain stimulation (DBS) are not impacted by pre-existing leukoaraiosis. Further studies are needed to validate our findings.

摘要

目的

我们试图评估脑白质疏松(LA)对接受脑深部电刺激(DBS)的帕金森病(PD)患者运动结局的影响。我们假设LA与PD患者DBS术后运动功能改善较少有关。

方法

我们回顾了2012年至2021年期间在单一中心接受DBS治疗的成年PD患者的数据。收集了人口统计学、危险因素、用药情况、Hoehn和Yahr分级量表以及DBS前后的统一帕金森病评定量表(UPDRS)运动评分和LA的严重程度。采用简单线性回归(SLR)来确定纳入多重线性回归(MLR)的感兴趣变量。MLR用于确定DBS术后运动结局(UPDRS)的独立预测因素,包括将LA作为连续变量和二分变量纳入感兴趣的变量。

结果

共有90例患者纳入分析。平均年龄为65.7岁(±9.7),主要为男性(69%),青年型PD发病率高(29%),接受卡比多巴/左旋多巴联合治疗(98%),疾病严重程度为中度(Hoehn和Yahr分期2.0[2.0,2.5])。26例(32.5%)患者存在中度至重度脑白质疏松。SLR显示年龄、糖尿病和疾病严重程度是DBS术后运动UPDRS的预测因素。在调整分析中,LA无论是作为连续变量(β = 0.20,p = 0.77)还是二分变量(β = -0.64;p = 0.77),都不是DBS术后运动结局的独立预测因素。

结论

总之,我们的数据表明,既往存在的脑白质疏松不会影响接受脑深部电刺激(DBS)的帕金森病患者的运动结局。需要进一步研究来验证我们的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/722b/12143692/df6f98ba16b0/gr1.jpg

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