帕金森病自主神经功能障碍丘脑底核脑深部电刺激术治疗进展

Research progress of subthalamic nucleus deep brain stimulation in treatment of autonomic nerve dysfunction in Parkinson's disease

自主神经功能障碍是帕金森病的常见非运动症状,发生率高,涉及多系统功能紊乱,临床表现多样,严重影响患者生活质量。自主神经功能障碍可能是帕金森病晚期的主要症状,也是患者病残的主要原因。丘脑底核脑深部电刺激术(STN-DBS)是帕金森病中晚期的有效治疗方法,对运动症状的改善作用已得到广泛认可,但对自主神经功能障碍的作用尚未完全阐明。本文综述STN-DBS对帕金森病自主神经功能障碍的治疗进展,提高临床对自主神经功能障碍症状的重视程度,并对术前评估、靶点选择、刺激参数设定、药物调整、术后疗效判定等得以综合考虑,制定个体化治疗方案。

Autonomic nerve dysfunction is a common non-motor symptom of Parkinson's disease(PD).It has a high incidence and involves multiple organ system disorders with various manifestations,seriously affecting the quality of life.Autonomic nerve dysfunction can be a major symptom of advanced PD and a major cause of disability.Subthalamic nucleus deep brain stimulation(STN-DBS)is an effective treatment for advanced PD,and its improvement of motor symptoms in PD patients has been widely recognized.However,the effect of STN-DBS on the symptoms of autonomic nerve dysfunction in PD patients is still unclear.Here,the efficacy of STN-DBS on PD autonomic nerve dysfunction is briefly reviewed.Therefore,we should pay more attention to the symptoms of autonomic nerve dysfunction in PD patients,and conduct preoperative evaluation of DBS in PD patients,so as to comprehensively consider the postoperative efficacy,target selection,stimulus parameter setting,drug adjustment,develop an individualized treatment plan.