丘脑底核电刺激治疗帕金森病的临床应用

目的探讨丘脑底核(STN)脑深部电刺激术(DBS)治疗帕金森病(PD)的手术方法和脉冲发生器的程控调节。方法行STN DBS治疗PD61例,其中单侧30例,双侧31例。采用磁共振扫描结合微电极记录技术进行靶点定位。术后用UPDRS运动评分评价刺激效果。结果术后随访6～36个月,平均11.3个月。脉冲发生器开启时,在“关”状态下,UPDRS运动评分改善率5.2%;在“开”状态下,UPDRS运动评分改善率20.7%,未发现任何并发症。结论STN DBS能有效控制PD症状,手术并发症少,术后可调节参数,已成为治疗PD的重要手术方法。

Clinical application of subthalamic nucleus stimulation for Parkinson disease

Objective To describe the technical approach and assess the efficacy and safety of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson disease (PD). Methods 61 patients with medically intractable PD underwent deep brain stimulation of the STN. Unilateral implanting was performed in 30 cases, and bilateral implanting was performed in 31 cases. The target was identified by a combination of MRI neuroimaging and microelectrode recording. The scores of the motor portion of the Unified PD rating scale (UPDRS) were recorded to evaluate the stimulative effect. Results The mean follow-up duration was 11.3 months (ranged from 6 to 36 months). Improvement of the UPDRS motor scores was 45.2% when the stimulation was turned on and 20.7% when the stimulation was turned off without any undesirable side effects. Conclusion The stimulation of STN results significant control of the motor symptoms of the patients, lacks complication, can adjust the parameters, and has become an important therapeutics of PD.