帕金森病丘脑底核电刺激术后脑多巴胺转运体变化

Dopamine transporter imaging of subthalamic nucleus deep brain stimulation in patients withParkinson＇s disease

目的分析帕金森病（PD）患者丘脑底核（STN）脑深部刺激术（DBS）治疗前后脑多巴胺转运体（DAT）浓度变化及其与疗效的关系，探讨DBS治疗机制。方法2011年2月至2011年7月，13例接受STN-DBS治疗的PD患者分别在术前1周和术后6个月行脑部“C-B-CFT．PET／CT扫描。结果PD患者纹状体各感兴趣区（ROI）DAT浓度明显降低（P〈0．05），并且术后进一步下降。术前尾状核、前壳核及后壳核DAT浓度与术前药物“开”期UPDRSⅢ评分呈明显负相关（R。分别为0．522、0．380、0．419）。术后尾状核、前壳核及后壳核DAT浓度与术后电刺激“开”期UPDRSm评分呈明显负相关（刚分别为0．402、0．350、0．307）。

Objective To determine the relationship between the change of dopamine transporter （DAT） and clinical efficacy of the subthalamic nucleus deep brain stimulation （STN-DBS）for Parkinson＇s Disease （PD） patients. Methods Between February 2011 and July 2011, 13 PD patients received I1C-β- CFT-PET/CT brain scan in a week before and 6 months after the STN-DBS treatment. Results The DAT in corpus striatum significantly decreased in all the patients and significantly decreased after surgery （ P 〈 0. 05 ）. The preoperative UPDRS ]U score with medication ＇on ＇was significant negative correlation with the preoperative DAT level in caudatum and putamen. The RZwere 0. 522, 0. 380, 0. 419 respectively. The negative correlation was also found between postoperative UPDRS ~I score with the postoperative DAT level when simulation was ＇on＇. The R2were 0. 402, 0. 350, 0. 307 respectively. The most correlated factor was the DAT level in eaudatum by muh-variable linear return analysis. Conclusions It was not found that the dopamine neuron was protected by STN-DBS. DAT level may be an objective indieator to estimate the efficacy of anti-parkinsonian therapy.