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用深度大脑刺激治疗的帕金森病患者的姿势不稳定性和跌倒风险:一个稳定计平台研究
Giorgio Leodori1,2, Marco Santilli1, Nicola Modugno1
1IRCCS Neuromed, 86077 Pozzilli, Italy.
Brain sciences
|September 28, 2023
概括
多巴胺药物恶化了帕金森病 (PD) 患者的平衡和跌倒风险. 深度大脑刺激 (DBS) 改善了平衡,特别是双边DBS与药物相结合时.
科学领域:
- 神经学 神经学
- 运动障碍 运动障碍
- 神经科学是一个神经科学.
背景情况:
- 帕金森病 (PD) 的特点是姿势不稳定 (PI),增加跌倒风险 (RF).
- 多巴胺类疗法和深度大脑刺激 (DBS) 用于晚期PD的运动症状,但它们对PI和RF的影响尚未完全理解.
研究的目的:
- 研究多巴胺类药物和DBS对晚期帕金森病患者的姿势不稳定性和跌倒风险的影响.
主要方法:
- 在稳定计平台上评估了6名晚期PD患者.
- 评估包括OFF和ON多巴胺激素药物状态.
- 测试了四种DBS设置:DBS关闭,双边DBS,单边DBS (受影响较大的侧面) 和单边DBS (受影响较小的侧面).
主要成果:
- 单独使用多巴胺药物会使PI和RF恶化.
- 仅使用DBS一开始就会降低RF.
- 没有药物-DBS组合比基线改善了姿势控制 (OFF药物,DBS关闭).
- 当使用ON药物时,DBS显著改善了PI和RF.
- 双边DBS在ON药物状态中显示出最大的益处,在OFF状态中出现最小的挫折.
- 更受影响的一方的单边DBS效果较差.
结论:
- 多巴胺疗法可能会加剧PD晚期的姿势不稳定.
- 深度大脑刺激,特别是双边DBS,可以改善姿势控制和降低晚期PD患者的跌倒风险,特别是与多巴胺药物药物相结合时.
- 这些发现可能会指导治疗策略,用于管理晚期PD的姿势障碍.
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