ジストニア性振戦に対する単一軌道後部視床下部領域および視床下部核深部脳刺激の有効性と安全性：後向きパイロットスタディ
Jianyi Shen1, Zhengyu Lin2, Suzhen Lin3
1Institute of Aging & Tissue Regeneration, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Objective:
To evaluate the feasibility, safety, and preliminary efficacy of a novel single-lead, dual-target deep brain stimulation (DBS) approach targeting the posterior subthalamic area (PSA) and subthalamic nucleus (STN) for dystonic tremor.
Methods:
This retrospective pilot study reviewed outcomes of six consecutive patients with medically refractory dystonic tremor who underwent single-lead PSA-STN DBS at our center (June-December 2024). Clinical outcomes were assessed using the BFMDRS and FTMTRS scales. A formal blinded crossover assessment was performed in three patients to compare PSA-only, STN-only, and combined stimulation. Chronic settings were selected via patient-directed optimization.
Results:
All six patients completed follow-up (100% retention) and achieved stable chronic stimulation programs. Five patients (83.3%) independently selected combined PSA + STN stimulation; one preferred STN-only. At LFU (6-12 months postoperatively), the mean BFMDRS-Motor score decreased by 78.1% and FTMTRS by 87.1%. The crossover assessment (n = 3) showed that combined stimulation outperformed single-target stimulation. No serious adverse events occurred. All efficacy analyses are exploratory.
Conclusion:
This single-lead, dual-target PSA-STN DBS approach demonstrates feasibility and preliminary efficacy for dystonic tremor. Prospective controlled trials are warranted.
