丘脑底核高频和低频电刺激治疗帕金森病的临床效果评价

Evaluation of the Clinical Efficacy of High and Low-frequency Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease

目的:观察和比较丘脑底核高频电刺激与低频电刺激治疗帕金森病(PD)的临床效果。方法:对入选的31名PD患者行双侧丘脑底核电刺激手术,术后1个月,在高频刺激条件下,进行UPDRS运动评分,同时对震颤、强直、运动迟缓、中轴症状进行评分;术后6个月,在关闭刺激、高频刺激和低频刺激三种刺激条件,同样进行相关评分。结果:术后1个月和术后6个月,除中轴症状外,UPDRS运动评分和震颤、强直、运动迟缓评分均较术前明显降低(P<0.05)。术后6个月,HFS、LFS刺激条件下,UPDRS运动评分和震颤、强直、运动迟缓评分均较OFF降低(P<0.05),但中轴症状评分无明显降低(P>0.05)。术后6个月,LFS较HFS,各项评分均无明显差异。结论:丘脑底核高频和低频电刺激均能改善PD的运动功能,对震颤、强直和运动迟缓疗效明显,但对中轴症状均无明显治疗效果。

Objective： To evaluate the clinical efficacy of High and low-frequency subthalamic nucleus deep brain stimulation for Parkinson＇s disease （PD）. Methods： 31 participants with bilateral deep brain stimulation of the subthalamic nucleus were tested during HFS for 1 month after surgery, and were tested off stimulation, during LFS, and during HFS for 6 months after surgery. The total motor UPDRS scores, tremor, rigidity, bradykinesia and axial subscores were quantitatively examined. Results： Compared with before surgery, HFS significantly reduced UPDRS motor scores, and tremor, rigidity, braykinesia subscores, except axial subscores, at 1 month after surgery. When six months after surgery, the scores of the above tested items under HFS and LFS all were lower than under the OFF condition, except axial subscores. No differences between stimulation conditions were found for those scores. Conclusion： HFS and LFS both provided beneficial improvements in the motor function of PD, including tremor, rigidity, and bradykinesia, but didn＇t demonstrate to be effective in the treatment of axial symptoms.