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复杂的基本和反震的双重目标深度大脑刺激 - 一个5年的随访

Hilary Shepherd¹, Rosie Heartshorne², Jibril Osman-Farah²

¹The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK; University of Liverpool Medical School, Liverpool, UK.

Journal of the neurological sciences

|January 31, 2024

概括

腹中中间核 (VIM) 和尾部不确定的区域 (cZI) 的双边双重向深度大脑刺激 (DBS) 在5年内有效地减少了患有基本震 (ET) 和静脉震 (DT) 的患者的震症状,ET的结果更好.

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:

基本震 (ET) 和 dystonic震 (DT) 的特点是动作震.
腹中中间核 (VIM) 的深度大脑刺激 (DBS) 是对耐火震的常见治疗方法.
由于VIM DBS的效率下降,需要探索其他替代目标.

研究的目的:

为了评估双边双重向VIM/caudal zona incerta (cZI) 刺激对震控制的疗效.
为了比较ET和DT患者之间的VIM/cZI DBS的疗效.

主要方法:

对36名ET或DT患者的回顾性研究.
在基线,1,3,5年后进行VIM/cZI DBS植入和评估.
结果包括Fahn-Tolosa-Marin震评级表,EuroQol-5D和医院焦虑和抑郁量表.

主要成果:

双边VIM-cZI DBS在3年内显著提高了45.1%的震得分 (p < 0.001).
震的改善在5年后持续 (30.7%的减少),尽管在统计学上并不显著.
没有观察到情绪或生活质量得分的显著改善.
基本震患者的临床结果明显优于性震患者 (p > 0.001).

结论:

双边VIM-cZI DBS在5年内为震患者提供持续的运动症状改善,特别有利于ET患者.
治疗对情绪和生活质量的影响有限.
对于ET和DT的结果在情绪和生活质量方面是相似的,但ET的运动改善更大.

关键词:

深度大脑刺激是什么?牙 - 牙 - 乳头 - 乳头管道.消极性震的震.基本的震震.后部亚thalamic 区域 (PSA) 后部亚thalamic 区域泰拉马斯 (ViM) 的腹腔中间核

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