一个急性发病的病例,在下丘脑核深脑刺激调整后,路径的耐火性结
Brendan Baugher1, Ellen Walter1, Erica Hennigs1
1Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, USA.
Cureus
|September 8, 2025
概括
脑下核深度大脑刺激 (STN-DBS) 很少会导致帕金森病患者的步态结 (FoG). 这一案例突显了刺激调整后的FOG发作,即使设备关闭时也会持续存在,这是一个罕见且不太了解的现象.
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:
- 步态结 (FoG) 是帕金森病 (PD) 的一个衰弱的症状.
- 亚thalamic核深脑刺激 (STN-DBS) 有效地管理PD运动症状,但其对FoG的影响是可变的.
- 矛盾的是,STN-DBS可以在某些患者中诱导或恶化FoG.
研究的目的:
- 在STN-DBS调整后报告一种独特的阳性发育的FOG病例.
- 调查刺激参数变化后FoG诱导背后的潜在机制.
- 为了强调耐火性后STN-DBS FoG的稀有性和复杂性.
主要方法:
- 一个62岁的女性病例报告,患有异常性PD,接受STN-DBS治疗.
- 与插入,激活和刺激调整相关的FoG发病时间的分析.
- 评估刺激参数 (频率,领先位置) 和药物效应.
- 在刺激"开启"和"关闭"状态期间评估FoG严重程度.
主要成果:
- 在STN-DBS刺激调整后两天,FoG发生,而不是插入或初始激活.
- 尽管对刺激参数和药物进行了多次调整,但FoG仍然存在,包括在设备"关闭"试验期间.
- 低频刺激 (55 Hz) 仅提供了部分的,暂时的FOG改善.
- 证实了STN内部的活跃联系,排除了严重的错位.
结论:
- 这一案例呈现出一种罕见的耐火性FoG在STN-DBS调整后出现的罕见实例,与之前报告的病因学不同.
- 持续的FOG,即使设备关闭,表明持久的不良影响可能与刺激调整相关.
- 对位和刺激参数进行进一步的全面报告对于在STN-DBS后了解和管理阳性FoG至关重要.
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