自然疾病进展与DBS相关的基本震恶化相比
Nisrine Bakri1, Adolfo Ramirez-Zamora2, Michael S Okun2
1Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, USA.
medRxiv : the preprint server for health sciences
|December 25, 2025
概括
随着时间的推移,基本震的恶化主要是由于疾病的自然进展,而不是对深度脑刺激 (DBS) 的耐受性. 长期研究表明,对于基本震的DBS提供了缓解,但进展是疾病驱动的.
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:
- 基本震是一种普遍的,致残的运动障碍.
- 腹中中间核的深度大脑刺激 (DBS) 可以缓解症状,但好处可能会减少.
- 益处减少的原因包括疾病的进展,,习惯性或耐受性.
研究的目的:
- 分析单侧腹中介核DBS对基本震的长期影响.
- 为了区分自然疾病进展与DBS相关的震恶化的原因.
- 评估在延长后续期间对逆侧和逆侧四肢的震进展情况.
主要方法:
- 对86名患有单边DBS的基本震患者进行了回顾性纵向分析.
- 平均随访时间为5.2年 (最大为15.4年),总访问次数超过470次.
- 使用Fahn-Tolosa-Marin震评级尺度量化震的严重程度,比较刺激和非刺激侧面的激发/关闭.
主要成果:
- 反侧震和双侧震呈现缓慢的双边进展,与自然疾病进展相一致.
- DBS显示没有可测量的跨半球影响;与激发/关闭激发相似的ipsilateral震进展.
- 刺激的肢体震进展反映了非刺激的肢体,表明疾病进展,而不是DBS耐受性或下降.
结论:
- 单边DBS的基本震患者的长期恶化的震主要是由自然疾病进展驱动的.
- 与深度大脑刺激相关的诸如习惯性或耐受性等原因在这个队列中没有被观察到是主导因素.
- 强调需要全面的,长期的结果评估,以区分疾病进展与治疗效应在基本震管理.
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