丘脑底核脑深部刺激术治疗帕金森病的手术方法和疗效分析

Technical approach and effects of deep brain stimulation of the subthalamic nucleus in Parkinson's disease.

目的 总结帕金森病(PD)脑深部刺激术(DBS)治疗的手术方法和效果。方法 对25例帕金森病患者进行了丘脑底核DBS治疗,其中单侧17例,双侧8例。采用磁共振扫描结合微电极记录技术进行靶点定位。术后用UPDRS运动评分评价刺激效果。结果 25例PD患者术后随访5～34个月,平均8.3个月。脉冲发生器开启时,在“关”状态下,UPDRS运动评分改善率50.2％;在“开”状态下,UPDRS运动评分改善率20.7％,未发现任何并发症。结论 丘脑底核DBS是改善PD患者运动功能较为理想的治疗方法。

Objective To describe the technical approach and to assess the efficacy and safety of deep brain stimulation of the subthalamic nucleus in Parkinson's disease(PD). Methods Twenty-five patients with medically intractable PD underwent unilateral subthalarnic (17 case) or bilateral subthalarnic (8 case) stimulation. The target was identified by a combination of MR neuroimaging and microelectrode recording. We compared scores on the motor portion of the unified Parkinson's disease rating scale (UPDRS) when the stimulation was turned on or off. Results The mean follow-up duration was 8.3 months(range 5 - 34 months). When the pulse generator was turned on, improvement of the UPDRS motor scores was 50.2% during the 'off' status and 20.7% during the 'on status without any undesirable side effects. Conclusions Our finding showed that subthalamic nucleus stimulation can significantly control the motor symptoms of the PD patients.