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Asra Askari¹, Jordan L W Lam¹, Brandon J Zhu²

¹Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States.

Frontiers in pain research (Lausanne, Switzerland)

|September 4, 2023

概括

脑下深层刺激 (STN DBS) 可以改善帕金森病的疼痛,当刺激是更多的背部. 这种疼痛缓解发生在最佳运动改善部位的背部,可能涉及不确定的区域.

科学领域:

神经学神经学
神经外科神经外科
疼痛管理疼痛管理

背景情况:

帕金森病 (PD) 经常涉及非运动性症状,如疼痛.
脑下深层大脑刺激 (STN DBS) 对PD疼痛表现出不同的影响.
最佳的活性接触位置可能会影响STN DBS的疼痛减轻效果.

研究的目的:

模拟和比较最佳的刺激位置,以减少疼痛与运动改善STN DBS帕金森病.
为了研究活跃接触位置和STN DBS后疼痛改善之间的关系.

主要方法:

运动障碍学会统一PD评分表 (MDS-UPDRS) 疼痛和运动评分在74名PD患者的STN DBS前后被评估.
普通最小平方回归分析了活跃接触位置作为疼痛改善的预测指标,控制了基线疼痛,年龄和药物.
一个与亚特拉斯无关的电场模型确定了对于疼痛和运动症状的最大有效刺激部位.

主要成果:

在PD患者中,STN DBS显著改善了疼痛评分 (p=0.01).
更多的背部活跃接触位置是疼痛改善的唯一显著预测因素 (R2=0.17,p=0.03).
缓解疼痛的最佳刺激位置位于运动改善的位置的侧面,前面和背部.

结论:

针对最佳运动改善部位的背部区域的STN刺激有效地减少了帕金森病的疼痛.
这种疼痛调节区域可能涉及不确定区域,它以其在人类疼痛调节中的作用而闻名.

关键词:

帕金森病是帕金森氏症的一种疾病.深度大脑刺激刺激大脑运动障碍学会统一的帕金森病评级表 (MDS-UPDRS)疼痛疼痛疼痛疼痛亚体的细胞核.

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