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在帕金森病中慢性深脑刺激前后探索心血管自主功能

Ilaria Cani^1,2, Giulia Giannini^1,2, Pietro Guaraldi²

¹Department of Biomedical and NeuroMotor Sciences (DIBINEM), Alma Mater Studiorum-University of Bologna, Bologna, Italy.

Movement disorders clinical practice

|May 3, 2024

概括

脑下深层刺激 (STN-DBS) 在帕金森病 (PD) 中不会改变血压控制. 然而,利沃多巴显著降低血压,STN-DBS降低了利沃多巴诱导的正静性低血压.

科学领域:

神经学神经学
心血管生理学心血管生理学
神经外科神经外科

背景情况:

帕金森病 (PD) 管理涉及复杂的血压调节.
自主功能障碍和勒沃多巴治疗显著影响了PD患者的血压,这些患者接受了脑下大脑深度刺激 (STN-DBS).

研究的目的:

研究慢性STN-DBS,莱沃多巴及其组合对帕金森病患者心血管自主功能的影响.

主要方法:

心血管反射测试 (CRT) 对20名PD患者进行了STN-DBS手术前和6个月后的心血管反射测试.
在没有药物 (med-OFF) 和有药物 (med-ON) 的情况下进行CRT.

主要成果:

在医疗关闭状态下,在STN-DBS前后之间没有观察到CRT结果或神经性正静性低血压 (OH) 的显著差异.
莱沃多巴的摄入导致在HUTT (头向上倾斜测试) 期间血压下降显著更大,相比于在STN-DBS前和后的med-OFF.
列沃多巴诱导的OH发生率从STN-DBS前的25%降低到STN-DBS后的5%在med-ON条件下.

结论:

慢性STN-DBS似乎不会影响PD患者的心血管自主反应.
列沃多巴显著影响血压,导致低血压效应.
通过STN-DBS手术,减少了勒沃多巴诱导的正静性低血压的发生.

关键词:

晚期的帕金森病已经发展为帕金森病.自主性故障的失败深度大脑刺激刺激大脑神经刺激的神经刺激静态静态低血压静态静态低血压

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