对于基本震的后部亚thalamic区域刺激:长期的疗效和刺激相关的副作用的挑战平衡
Ines Debove1, Mara Beuster1, Mario Sousa1
1Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Parkinsonism & related disorders
|February 7, 2026
概括
在后脑下垂体区域 (PSA) 的深度大脑刺激 (DBS) 提供持续的基本震 (ET) 减少. 然而,患者经常经历刺激诱导的副作用,需要谨慎管理.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 医疗器械 医疗器械
背景情况:
- 深度大脑刺激 (DBS) 是一种已建立的治疗药物耐药性基本震 (ET) 的方法.
- 后部亚thalamic区域 (PSA) DBS是一个较新的目标,与传统的腹腔中间核 (Vim) 目标相比,它具有潜在的优势.
- 本研究评估了PSA-DBS对ET的长期结果.
研究的目的:
- 评估后脑下垂体区域深度大脑刺激 (PSA-DBS) 在基本震 (ET) 患者的长期疗效.
- 评估与ET中PSA-DBS相关的长期副作用概况.
- 将PSA-DBS结果与ET的Vim-DBS现有文献进行比较.
主要方法:
- 评估了接受双边PSA-DBS的14名ET患者.
- 法恩-托洛萨-马林震评分表被用于预手术,12个月后,以及最后一次随访 (10-63个月) 的疗效评估.
- 系统的单极测试确定了震抑制和副作用的值;神经学检查和视频评估记录了不良事件.
主要成果:
- 观察到显著的震减缓,在12个月后减少了59%,在最后一次随访时减少了39%.
- 常见的副作用包括动力障碍 (93%),步态障碍 (79%) 和动力不良 (57%),一般为轻度至中度.
- 报告的患者满意度很高 (85.7%),尽管21%的患者经历了刺激诱导的运动障碍.
结论:
- 双边PSA-DBS为基本震提供持续的震减轻.
- 频繁的刺激诱导的副作用需要警的长期监测和编程调整.
- PSA-DBS 是 ET 的一个可行的选择,但仔细管理对于最佳结果至关重要.
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