Some studies have shown that low frequency stimulation(LFS,most commonly 60 Hz),compared to high frequency stimulation(HFS,most commonly 130 Hz),has beneficial effects,short-term or even long-term,on improving freezin...Some studies have shown that low frequency stimulation(LFS,most commonly 60 Hz),compared to high frequency stimulation(HFS,most commonly 130 Hz),has beneficial effects,short-term or even long-term,on improving freezing of gait(FOG)and other axial symptoms,including speech and swallowing function,in Parkinson disease(PD)patients with bilateral subthalamic nucleus deep brain stimulation(STN DBS).However,other studies failed to confirm this.It seems not clear what determines the difference in response to LFS.Differences in study design,such as presence or absence of FOG,exact LFS used(60 Hz versus 80 Hz),study size,open label versus randomized double blind assessment,retrospective versus prospective evaluation,medication On or Off state,total electric energy delivered maintained or not with the change in frequency,and the location of active contacts could all potentially affect the results.This mini-review goes over the literature with the aforementioned factors in mind,focusing on the effect of LFS versus HFS on FOG and other axial symptoms in PD with bilateral STN DBS,in an effort to extract the essential data to guide our clinical management of axial symptoms and explore the potential underlying mechanisms as well.Overall,LFS of 60 Hz seems to be consistently effective in patients with FOG at the usual HFS in regards to improving FOG,speech,swallowing function and other axial symptoms,though LFS could reduce tremor control in some patients.Whether LFS simply addresses the axial symptoms in the context of HFS or has other beneficial effects requires further studies,along with the mechanism.展开更多
目的探讨Bryan人工颈椎间盘置换术与颈前路椎间融合术后颈部轴性症状(axial symptom,AS)的发生,并进行对比分析。方法2004年10月-2006年4月,对22例患者行Bryan人工颈椎间盘置换术(A组),男13例,女9例;年龄33～54岁,平均43.3岁。病程1～2...目的探讨Bryan人工颈椎间盘置换术与颈前路椎间融合术后颈部轴性症状(axial symptom,AS)的发生,并进行对比分析。方法2004年10月-2006年4月,对22例患者行Bryan人工颈椎间盘置换术(A组),男13例,女9例;年龄33～54岁,平均43.3岁。病程1～21个月,平均6个月。其中脊髓型颈椎病16例,神经根型颈椎病6例。单节段置换20例,2个节段置换2例。对同期30例患者行颈前路椎间盘切除减压植骨融合内固定术(B组),男17例,女13例;年龄35～64岁,平均50.3岁。病程1～23个月,平均7个月。其中脊髓型颈椎病19例,神经根型颈椎病11例。单节段融合26例,2个节段融合4例。观察两组患者术后随访时神经功能恢复情况,手术节段颈椎曲度、颈椎总活动度(range of motion,ROM)的变化情况及颈部AS的发生情况,并进行比较分析。结果两组患者术中、术后均无严重并发症发生。所有患者均获随访,随访时间24～42个月,平均30.6个月。A组术后无假体移位、脱落等并发症发生;B组术后6个月X线片示植骨全部达骨性融合,内固定无松动、脱落、断裂等。两组神经根型患者术后随访时临床症状均明显缓解,疗效满意。两组脊髓型患者JOA评分术后随访时均较术前有明显提高(P<0.01);两组术前及随访期末差异均无统计学意义(P>0.05)。B组术后手术节段颈椎后凸发生率明显增高,且高于A组(P<0.05)。B组ROM较术前明显减小(P<0.01),A组手术前后差异无统计学意义(P>0.05);两组术后差异有统计学意义(P<0.05)。术后颈部AS发生率A组为18.18%,B组为46.67%,两组比较差异有统计学意义(P<0.05)。结论与前路融合手术相比,Bryan人工颈椎间盘置换治疗颈椎病在取得良好临床疗效的同时能维持手术节段ROM及曲度,避免ROM的减少及术后颈部AS的发生。展开更多
文摘Some studies have shown that low frequency stimulation(LFS,most commonly 60 Hz),compared to high frequency stimulation(HFS,most commonly 130 Hz),has beneficial effects,short-term or even long-term,on improving freezing of gait(FOG)and other axial symptoms,including speech and swallowing function,in Parkinson disease(PD)patients with bilateral subthalamic nucleus deep brain stimulation(STN DBS).However,other studies failed to confirm this.It seems not clear what determines the difference in response to LFS.Differences in study design,such as presence or absence of FOG,exact LFS used(60 Hz versus 80 Hz),study size,open label versus randomized double blind assessment,retrospective versus prospective evaluation,medication On or Off state,total electric energy delivered maintained or not with the change in frequency,and the location of active contacts could all potentially affect the results.This mini-review goes over the literature with the aforementioned factors in mind,focusing on the effect of LFS versus HFS on FOG and other axial symptoms in PD with bilateral STN DBS,in an effort to extract the essential data to guide our clinical management of axial symptoms and explore the potential underlying mechanisms as well.Overall,LFS of 60 Hz seems to be consistently effective in patients with FOG at the usual HFS in regards to improving FOG,speech,swallowing function and other axial symptoms,though LFS could reduce tremor control in some patients.Whether LFS simply addresses the axial symptoms in the context of HFS or has other beneficial effects requires further studies,along with the mechanism.
文摘目的探讨Bryan人工颈椎间盘置换术与颈前路椎间融合术后颈部轴性症状(axial symptom,AS)的发生,并进行对比分析。方法2004年10月-2006年4月,对22例患者行Bryan人工颈椎间盘置换术(A组),男13例,女9例;年龄33～54岁,平均43.3岁。病程1～21个月,平均6个月。其中脊髓型颈椎病16例,神经根型颈椎病6例。单节段置换20例,2个节段置换2例。对同期30例患者行颈前路椎间盘切除减压植骨融合内固定术(B组),男17例,女13例;年龄35～64岁,平均50.3岁。病程1～23个月,平均7个月。其中脊髓型颈椎病19例,神经根型颈椎病11例。单节段融合26例,2个节段融合4例。观察两组患者术后随访时神经功能恢复情况,手术节段颈椎曲度、颈椎总活动度(range of motion,ROM)的变化情况及颈部AS的发生情况,并进行比较分析。结果两组患者术中、术后均无严重并发症发生。所有患者均获随访,随访时间24～42个月,平均30.6个月。A组术后无假体移位、脱落等并发症发生;B组术后6个月X线片示植骨全部达骨性融合,内固定无松动、脱落、断裂等。两组神经根型患者术后随访时临床症状均明显缓解,疗效满意。两组脊髓型患者JOA评分术后随访时均较术前有明显提高(P<0.01);两组术前及随访期末差异均无统计学意义(P>0.05)。B组术后手术节段颈椎后凸发生率明显增高,且高于A组(P<0.05)。B组ROM较术前明显减小(P<0.01),A组手术前后差异无统计学意义(P>0.05);两组术后差异有统计学意义(P<0.05)。术后颈部AS发生率A组为18.18%,B组为46.67%,两组比较差异有统计学意义(P<0.05)。结论与前路融合手术相比,Bryan人工颈椎间盘置换治疗颈椎病在取得良好临床疗效的同时能维持手术节段ROM及曲度,避免ROM的减少及术后颈部AS的发生。
