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亚thalamic核刺激对尿路功能障碍和在帕金森病中便秘的影响

Asra Askari¹, Brandon J Zhu², Jordan L W Lam¹

¹Departments of1Neurological Surgery.

Journal of neurosurgery

|September 29, 2023

概括

脑下核深度大脑刺激 (DBS) 对帕金森病 (PD) 泌尿和便秘问题的结果各不相同. 较大的全球脑缩预测尿路恶化,而前电极接触改善便秘.

科学领域:

神经学神经学
神经外科神经外科
运动障碍运动障碍

背景情况:

尿路功能障碍和便秘是帕金森病 (PD) 的常见非运动症状.
脑下核深度大脑刺激 (STN-DBS) 是PD运动症状的治疗方法,但它对尿路功能障碍和便秘等非运动症状的影响是可变的.

研究的目的:

确定在帕金森病患者中预测尿路功能障碍和便秘的STN-DBS结果的手术和非手术变量.
调查全球脑缩 (GCA),活性电极接触位置和STN-DBS后非运动症状变化之间的关系.

主要方法:

利用运动障碍学会统一的帕金森病评分表 (MDS-UPDRS) 第一部分,评估手术前和手术后 (6-12个月) 的尿道和便秘症状.
采用多重线性回归来分析GCA和电极接触位置对症状得分的影响,控制相关的临床变量.
应用电场模型来确定运动和非运动症状的最佳刺激部位.

主要成果:

在74名患者中,23例尿路功能障碍改善,28例恶化,23例无变化. 便秘在25个改善,在15个恶化,在34个保持不变.
全球脑缩 (GCA) 评分和患者年龄显著预测了泌尿功能障碍随访得分 (R2 = 0.36,p < 0.001),高GCA和年龄与症状恶化有关.
疾病持续时间,基线便秘得分和前部活性电极接触预测了便秘随访得分 (R2 = 0.31,p < 0.001),较长的疾病持续时间和较高的基线得分与恶化有关,前部接触与改善有关.

结论:

在STN-DBS中前置活性电极接触放置与帕金森病患者的便秘改善有关.
在手术前患有较大的全球脑缩 (GCA) 的帕金森病患者在STN-DBS后面面临更高的尿功能障碍恶化的风险.

关键词:

帕金森病是帕金森病的一种疾病.便秘便秘便秘便秘深度大脑刺激刺激大脑功能神经外科功能神经外科亚体的细胞核.尿路功能障碍尿路功能障碍

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