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编程算法用于管理语音障碍在体下细胞核帕金森病的深度大脑刺激

Bart E K S Swinnen¹, Veronia Lotfalla¹, Marije N Scholten¹

¹Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands.

Neuromodulation : journal of the International Neuromodulation Society

|July 15, 2023

概括

发言障碍在接受脑下核 (STN) 深度脑刺激 (DBS) 的帕金森病患者中很常见. 重编程DBS设置提供了有限的持续改进,需要基于证据的方法来获得更好的结果.

科学领域:

神经科学是一个神经科学.
神经学神经学
神经外科神经外科

背景情况:

发言障碍是帕金森病 (PD) 患者经常面临的挑战,这些患者接受了下丘脑核深度大脑刺激 (STN-DBS).
STN-DBS与语音之间的关系是复杂的,具有诱导副作用和治疗益处的潜力.
目前对STN-DBS相关语音障碍的管理缺乏标准化,基于证据的协议,严重依赖临床经验.

研究的目的:

开发一种基于证据和经验的算法,用于在接受STN-DBS治疗的PD患者中管理言语障碍.
巩固现有证据和临床见解,以指导语音缺陷的DBS重编程.

主要方法:

一个单一中心的回顾性研究确定了STN-DBS和语音障碍患者,收集了关于发病,位和对DBS调整的反应的数据.
进行了一项系统的文献审查,以找到关于改善STN-DBS对PD的语音参数调整的研究.
收集了DBS重编程后语音改善的程度和持续时间的数据.

主要成果:

38.8%的STN-DBS患者 (245/631) 经历了显著的语言障碍.
在重新编程DBS设置后,持续明显改善的概率很低 (27.9%).
一项系统性审查包括了23项研究,但只有两项随机对照试验专注于交联-交联刺激,显著的异质性阻止了元分析.

结论:

语音障碍是PD中STN-DBS的常见并发症,对有效的参数调整的高质量证据有限.
通过DBS重编程来实现持续的语音改进的可能性很低.
提出了一个基于证据和经验的算法,以加强对STN-DBS治疗PD的语音障碍的临床管理.

关键词:

在 DBS 中,DBS 是 DBS 的代名词.帕金森病是帕金森氏症的一种疾病.脱节性关节障碍症脱节性关节障碍症是一种疾病.语言障碍语言障碍语言障碍亚体的细胞核.

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