双侧苍白球内侧部脑深部电刺激治疗迟发性运动障碍

Bilateral GPi-DBS as a treatment of tardive dyskinesia

目的:探讨苍白球内侧部(GPi)脑深部电刺激(DBS)治疗严重迟发性运动障碍(TD)的有效性和安全性。方法:对7例TD患者行双侧GPi-DBS治疗,术前、开机后1个月、3个月及12个月用BFMDRS量表评估患者疗效。精神症状评估采用临床疗效总量表严重程度分量表(CGI-SI)。结果:7例患者开机后1个月BFMDRS运动评分改善52.90%,BFMDRS功能障碍评分改善47.58%;开机后3个月BFMDRS运动评分改善60.74%,BFMDRS功能障碍评分改善55.83%;开机后12个月BFMDRS运动评分改善71.08%,BFMDRS功能障碍评分改善68.01%。7例患者开机后1个月、3个月及12个月CGI-SI评分均未见升高(P>0.05)。所有患者均未出现手术并发症。结论:双侧GPi-DBS是治疗TD安全、有效的方法。

Objective To investigate the effectiveness and safety of deep brain stimulation to the globus pallidus interior(GPi-DBS)as a treatment of severe tardive dyskinesia(TD)in the.Methods Seven patients with TD were treated with bilateral GPi-DBS.The curative effect of the patients was evaluated with the Burke Fahn Marsden Dystonia Rating Scale(BFMDRS)at baseline and at 1,3 and 12 months after start of GPi-DBS.Psychiatric symptoms were assessed using Clinical Global Impression-Severity of Illness Scale(CGI-SI).Results All patients experienced improvements in BFMDRS motor score by 52.90%and in dysfunction score by 47.58%at 1 month;60.74%and 55.83%,at 3 months;71.08%,and 68.01%at 12 months after start of GPi-DBS.There was no increase in CGI-SI scores in the 7 patients at 1,3 and 12 months after start of GPi-DBS(P>0.05).No complications occurred in anyone of the patients.Conclusion Bilateral GPi-DBS is a safe and effective treatment for TD.