双侧丘脑底核脑深部电刺激术治疗帕金森病(附33例报道)

目的总结双侧脑深部电刺激术(DBS)治疗帕金森病(PD)的手术方法和效果。方法对具有严重双侧症状和轴性症状的33例PD病人进行同期双侧丘脑底核DBS治疗。采用磁共振扫描结合微电极记录技术进行靶点定位。术后采用统一帕金森病评定量表(UPDRS)运动评分评价刺激效果。结果术后随访3个月~4年,平均7.3个月。脉冲发生器开启时,UPDRS运动评分平均改善率在“关”状态下为62.3%,在“开”状态下为24.2%。记忆力下降2例,情绪改变7例,睁眼困难1例,肢体异动15例;无明显的致残性永久并发症和副作用。结论双侧丘脑底核DBS手术的安全性较高,可明显改善PD病人的运动功能。

Dual channel deep brain stimulation system of the bilateral subthalamic nucleus for treatment of Parkinson disease: 33 cases report

Objective To evaluate the safety and efficacy of a new dual channel deep brain stimulation (DBS) system for treatment of Parkinson disease (PD). Methods Thirty-three patients with medically intractable PD underwent simultaneous bilateral subthalamic nucleus stimulation. The target was identified by a combination of MRI neuroimaging and microelectrode recording. We compared scores on the motor portion of the Unified Parkinson disease rating scale (UPDRS) when the stimulation was turned on or off. Results The mean follow-up duration was 7.3 months (ranging from 3 to 48 months). When the stimulation was turned on, improvement rate of the UPDRS motor scores was 62.3% under off-status and 24.2% under on-status. Mild memory decline was observed in 2 cases, mood changes in 7 cases, eyelid opening apraxia in one case, and dyskinesias in 15 cases. No serious adverse events and permanent morbidity were observed in the cohort. Conclusion Bilateral subthalamic nucleus stimulation is a minimally invasive procedure and achieves significant control of the motor symptoms of the patients.