[1]郑小斌,余良宏,万欣龙,等.颅内电极重建在帕金森病患者脑深部刺激治疗中的应用价值[J].南方医科大学学报,2019,(12):1461-1468.[doi:10.12122/j.issn.1673-4254.2019.12.10]
 Application of intracranial lead reconstruction in deep brain stimulation therapy in patients with Parkinson’s disease[J].Journal of Southern Medical University,2019,(12):1461-1468.[doi:10.12122/j.issn.1673-4254.2019.12.10]
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颅内电极重建在帕金森病患者脑深部刺激治疗中的应用价值()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2019年12期
页码:
1461-1468
栏目:
出版日期:
2020-01-01

文章信息/Info

Title:
Application of intracranial lead reconstruction in deep brain stimulation therapy in patients with Parkinson’s disease
作者:
郑小斌余良宏万欣龙王惠清俞 挺何 秋林章雅康德智
关键词:
帕金森病脑深部刺激术电极重建电极植入位置
Keywords:
Parkinson’s disease deep brain stimulation lead reconstruction electrode implantation position
DOI:
10.12122/j.issn.1673-4254.2019.12.10
文献标志码:
A
摘要:
目的 评估颅内电极重建技术应用于帕金森病患者脑深部刺激术(DBS)临床治疗的可行性。方法 回顾性纳入2016年1 月~2017年12月接受双侧丘脑底核(STN)DBS治疗的帕金森病患者27例,基于本研究中颅内电极重建技术,根据植入电极与STN的位置关系,将病例分为3组(A组:双侧电极最佳DBS刺激触点均位于STN内;B组:仅一侧电极最佳刺激触点位于STN内;C组:双侧电极最佳刺激触点均不位于STN内)。统计分析3组病例在基线水平、术后6月、术后12月的Hoehn-Yahr分期、统一帕金森病评定量表第3部分(UPDRS Ⅲ)分值、Schwab & England 日常活动评分(SE-ADL)、左旋多巴等效剂量(LEDD)的差异,并进一步通过分析基于重建电极与标准开机程控两种方式筛选的最佳刺激触点的吻合度以及触点坐标的差异,判断该项技术的准确性与可靠性。结果 STN-DBS术后3组病例在药物-关期的H-Y分期、UPDRS Ⅲ分值、SE-ADL分值及LEDD均不同程度改善,但在术后12月,仅有组A病例的上述分值改善仍是显著的。基于重建电极与标准开机流程两种方式筛选的最佳触点的吻合度达77.78%(42/54),二者的触点空间坐标值差异无统计学意义(P>0.05)。结论 颅内电极重建技术有利于研究颅内电极植入位置与DBS临床疗效的相关性,符合术后程控最佳DBS触点筛选的精度需求。
Abstract:
Objective To evaluate the feasibility of applying intracranial lead reconstruction in deep brain stimulation (DBS) therapy for Parkinsonism. Methods We retrospectively collected the clinical data from 27 patients with Parkinson’s disease (PD), who received bilateral subthalamic nucleus (STN) DBS therapy between January, 2016 and December, 2017. According to the position of the selected optimal stimulating contact of the implanted leads, the patients were divided into group A with the stimulating contacts of the bilateral leads in the STN, group B with unilateral stimulating contacts in the STN, and group C with bilateral stimulating contacts outside the STN. All the patients were assessed for improvement using Hoehn-Yahr stage, the third part of United Parkinson’s Disease Rating Scale (UPDRS III), Schwab and England Activities of Daily Living (SE-ADL), and L-dopa equivalent daily dose (LEDD). The consistency between the optimal stimulating contact selected by lead reconstruction and that by standard postoperative programming procedure was also evaluated. Results The patients in all the 3 groups showed postoperative improvements in Hoehn-Yahr stage, UPDRS III score, SE-ADL score, and LEDD in the medication-off state. But at 12 months of the follow-up, such improvements were maintained only in the patients of group A. The optimal stimulating contacts selected by lead reconstruction and standard postoperative programming procedure had a matching rate of up to 77.78% (42/54), and the coordinates of the optimal contacts selected by the two methods showed no significant difference. Conclusion Intracranial lead reconstruction facilitates the study of the association between the implant site of the leads and the clinical outcome of DBS therapy for PD and allows the precise selection of the optimal contact of the implanted leads in postoperative programming of DBS.

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更新日期/Last Update: 2019-12-27