微电极导向内侧苍白球腹后部毁损术改善帕金森病合并轻中度抑郁的机制

Analysis of curative effect to depression mood in Parkinson's disease by microelectrode guided posteroventral pallidotomy

目的分析评估微电极导向内侧苍白球腹后部毁损术对帕金森病(PD)合并轻中度抑郁的疗效,探讨其机制。方法PD合并轻、中度抑郁患者36例,于微电极导向单侧苍白球腹后部毁损术前10d及术后2周进行肢体运动功能障碍及抑郁疗效的评估。结果36例患者术后在肢体运动功能障碍明显改善的同时,其抑郁情绪亦有明显的改善,Webster记分、SDS总分、HAMD总分均较术前明显降低(P<0.01),有效率91.67%。靶点更换率100%,经微电极导向技术再确认的靶点较影像学确定的靶点更偏向内侧苍白球的内侧及腹侧。结论微电极导向的内侧苍白球腹后部毁损术对PD合并的轻、中度抑郁有明显的改善作用。

Objective To evaluate curative effect and mechanism to mild and moderate depression mood in Parkinson's disease by microelectrode guided posteroventral pallidotomy and analyse correlation with location lesion.Methods 36 cases of PD with mild or moderate depression mood underwent microelectrode guided posteroventral pallidotomy unilateraly under local anaesthesia.Results Both movement disorder of limbs and depression mood in all 36 cases were improved remarkably.Webster scale,SDS and HAMD were lower obviously than that of preoperation (P< 0.01 ).Effectiveness rate was 91.67%.Change rate of targets was 100%.Targets reconfirmed by techniques of microelectrode guided were made more ventrally and medially than targets determined by imaging techniques.Conclusion Microelectrode guided posteroventral pallidotomy can alleviate mild or moderate depression mood in PD distinctly.