深部脑电刺激治疗帕金森病的FDGPET研究

目的研究双侧丘脑底核慢性电刺激术对晚期帕金森病患者脑局部糖代谢的影响及作用机制.方法对7例进行双侧STN DBS的晚期帕金森病患者,在术前和术后1个月电刺激条件下,分别进行18F-脱氧葡萄糖(18F-FDG)PET显像和UPDRS评分,通过SPM进行数据分析.结果 7例患者临床症状明显改善,同时FDG PET显像提示双侧豆状核、脑干、顶枕部、运动前区(BA6)及扣带回的脑代谢增加,而前额叶底部及海马的脑代谢减少(P<0.05).结论双侧STN DBS可使PD患者临床症状改善.FDG PET可作为PD进行STN治疗适应证选择的方法之一.

Deep brain stimulation treatment for Parkinson's disease by using

Objective To study the effects of bilateral subthalamic nucleus (STN) stimulation on cerebral glucose metabolism of advanced Parkinson's disease (PD), and to investigate the mechanism of deep brain stimulation (DBS). Methods Seven advanced Parkinson's diseases patients with bilateral STN DBS underwent 18 F-FDG PET before and one month after operation with STN stimulation-on respectively. The unified Parkinson's disease rating scale (UPDRS) was used to evaluate the clinical state. Statistical parametric mapping (SPM) was used to analysis regional cerebral metabolism of glucose during bilateral STN stimulation. Results Bilateral STN stimulation improved the clinical symptoms obviously, while the regional cerebral metabolism increased in bilateral lentiform, brainstem (midbrain and pon), bilateral premotor area, parietal-occipital cortex and cingulate cortex, and decreased in the bottom of prefrontal cortex and hippocampus ( P <0.05). Conclusion Bilateral STN DBS may activate the projection axon from STN and improve the clinical symptoms of advanced PD patients, which perhaps improve both ascending and descending pathway from the basal ganglia and increase the metabolism of higher-order motor control of frontal cortex. FDG PET is one of the suitable methods to select the candidate for the STN.