在深度大脑刺激中考虑风险和益处 停止晚期帕金森病的深度大脑刺激
Pietro Antenucci1, Andrea Gozzi2, Fabiana Colucci3
1Unit of Clinical Neurology, Interdistrict Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
Movement disorders clinical practice
|February 14, 2026
概括
在晚期帕金森病 (LSPD) 中停止深度大脑刺激 (DBS) 对一些患者可能是可行的,但更长的DBS持续时间预测了持续的益处. 临床因素指导停止DBS治疗的决定.
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:
- 晚期帕金森病 (LSPD) 中的深度大脑刺激 (DBS) 管理在继续或停止治疗的决定方面提出了挑战.
- 关于在LSPD中对DBS管理的风险-收益考虑的证据有限.
研究的目的:
- 确定影响LSPD患者DBS管理决策的关键因素.
- 为了评估在LSPD中停止DBS的结果.
主要方法:
- 在LSPD患者的人口,临床和刺激参数的回顾性分析 (Hoehn和Yahr≥4;Schwab和英格兰≤50).
- 比较维持最佳医疗疗法 (BMT) 的患者与在DBS停止后需要非计划器件辅助疗法 (DAT) 的患者.
主要成果:
- 在31名LSPD患者中,15人继续接受BMT治疗,10人需要在停药后3个月内接受救援DAT治疗.
- 较长的DBS持续时间 (≥10.5年) 与减少救援DAT的需要有关 (或0.529).
- 趋势表明,在一些患者停止刺激后,运动恶化较少 (ΔMDS-UPDRS III).
结论:
- 选择的LSPD患者可以在DBS停止后单独过渡到BMT,并保持长期稳定.
- 对于其他人来说,持续的DBS刺激是值得的,由临床,治疗和护理相关因素指导.
- 在考虑在LSPD中中止DBS时,仔细考虑个体患者的因素至关重要.
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