苍白球内侧部脑深部电刺激治疗单纯型肌张力障碍的疗效分析

Analysis of the therapeutic effect of deep brain stimulation of the medial part of globus pallidus on isolated dystonia

目的评价双侧苍白球内侧部脑深部电刺激(GPi-DBS)治疗累及身体不同部位的单纯型肌张力障碍的临床效果。方法回顾总结昆明三博脑科医院自2017年10月至2021年09月采用GPi-DBS治疗的22例单纯型肌张力障碍患者的临床资料,采用国际通用的Burke-Fahn-Marsden肌张力障碍评定量表评分(运动部分)(BFMDRS),通过术前、术后12个月随访时的BFMDRS评分,评估患者运动功能的改善情况。结果22例患者手术过程顺利,术后12个月时进行疗效评价。患者的运动功能明显改善,术前BFMDRS评分为47.50(21.75,54.50),术后随访BFMDRS评分为6.00(1.75,9.75),术前与术后随访BFMDRS评分存在统计学差异(Z=4.453,P<0.001)。与术前相比术后随访时BFMDRS运动评分平均改善70.3%,总有效率为81.8%。结论GPi-DBS治疗累及身体不同部位的单纯型肌张力障碍的疗效显著;全身型肌张力障碍与非全身型肌张力障碍疗效之间无显著差异(P>0.05)。

Objective To evaluate the clinical effect of bilateral deep brain stimulation(GPi-DBS)for isolated dystonia involving different parts of the body.Methods The clinical data of 22 patients with isolated dystonia treated with GPi-DBS in Kunming Sanbo Brain Hospital from October 2017 to September 2021 were reviewed and summarized.The international Burke-Fahn-Marsden Dystonia Rating Scale(Motor component)(BFMDRS)was used.The improvement of motor function was evaluated by BFMDRS score before operation and 12 months after operation.Results The operation was successful in 22 patients,and the efficacy was evaluated 12 months after operation.The preoperative BFMDRS score was 47.50(21.75,54.50),and the postoperative BFMDRS score was 6.00(1.75,9.75).There was a significant difference between preoperative and postoperative BFMDRS scores(Z=4.453,P<0.001).The BFMDRS motor score was improved by 70.3%and the total effective rate was 81.8%.Conclusion Gpi-DBS is effective in treating isolated dystonia affects different parts of the body.There was no significant difference between generalized dystonia and segmental or focal dystonia(P>0.05).