GPi/GPe borderland- a potential sweet spot for deep brain stimulation for chorea in Huntington's disease?

Q2 Medicine Neurological research and practice Pub Date : 2024-05-23 DOI:10.1186/s42466-024-00316-5

Julia Steinhardt, Simone Zittel, Vera Tadic, Volker Tronnier, Christian Moll, Tobias Bäumer, Alexander Münchau, Dirk Rasche, Norbert Brüggemann

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Abstract

Background: Pallidal deep brain stimulation (GPi-DBS) has been considered as an effective treatment option for medication-refractory Huntington's disease (HD).

Objectives: To identify stimulation-dependent effects on motor symptoms and to determine if these alterations are associated with the local impact of DBS on different pallidal parcellations.

Methods: We prospectively evaluated the effects of bilateral GPi-DBS within one year in 5 HD patients. We evaluated the effects of GPi-DBS on choreatic symptoms and UHDRS. Electrode placement in the pallidum was localized, and the local impact of DBS was estimated.

Results: The chorea subscore (p < 0.001) and UHDRS total motor score was significantly reduced postoperatively (p = 0.019). Pallidal DBS did not improve other motor symptoms. Activation of the lateral GPi/GPe was associated with improvement in choreatic symptoms (p = 0.048; r = 0.90).

Conclusions: Our findings indicate that stimulation of the lateral GPi has a stable effect on choreatic symptoms. The modulation of the electrical field is relevant for motor outcome.

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GPi/GPe 边界--深部脑刺激治疗亨廷顿舞蹈症的潜在甜蜜点？

背景：苍白球深部脑刺激（GPi-DBS）被认为是治疗药物难治性亨廷顿氏病（HD）的有效方法：目的：确定刺激对运动症状的影响，并确定这些改变是否与DBS对不同丘脑旁的局部影响有关：我们对 5 名 HD 患者一年内双侧 GPi-DBS 的效果进行了前瞻性评估。我们评估了 GPi-DBS 对胆囊症状和 UHDRS 的影响。对苍白球的电极放置进行了定位，并估计了 DBS 对局部的影响：结果：胆汁淤积子分数（p 结论：GPi-DBS 对胆汁淤积症状和 UHDRS 有显著影响：我们的研究结果表明，刺激外侧 GPi 对胆囊症状有稳定的影响。电场的调节与运动结果有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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