Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: Exploratory Outcomes and Open-Label Extension.

IF 2.6 4区医学 Q2 CLINICAL NEUROLOGY Movement Disorders Clinical Practice Pub Date : 2024-08-13 DOI:10.1002/mdc3.14188

Karlo J Lizarraga, Bhairavei Gnanamanogaran, Tameem M Al-Ozzi, Melanie Cohn, George Tomlinson, Alexandre Boutet, Gavin J B Elias, Jürgen Germann, Derrick Soh, Suneil K Kalia, Mojgan Hodaie, Renato P Munhoz, Connie Marras, William D Hutchison, Andres M Lozano, Anthony E Lang, Alfonso Fasano

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引用次数: 0

Abstract

Background: A randomized trial suggested that reducing left-sided subthalamic stimulation amplitude could improve axial dysfunction.

Objectives: To explore open-label tolerability and associations between trial outcomes and asymmetry data.

Methods: We collected adverse events in trial participants treated with open-label lateralized settings for ≥3 months. We explored associations between trial outcomes, location of stimulation and motor asymmetry.

Results: 14/17 participants tolerated unilateral amplitude reduction (left-sided = 10, right-sided = 4). Two hundred eighty-four left-sided and 1113 right-sided stimulated voxels were associated with faster gait velocity, 81 left-sided and 22 right-sided stimulated voxels were associated with slower gait velocity. Amplitude reduction contralateral to shorter step length was associated with 2.4-point reduction in axial MDS-UPDRS. Reduction contralateral to longer step length was associated with 10-point increase in MDS-UPDRS.

Conclusions: Left-sided amplitude reduction is potentially more tolerable than right-sided amplitude reduction. Right-sided more than left-sided stimulation could be associated with faster gait velocity. Shortened step length might reflect contralateral overstimulation.

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侧位丘脑下刺激治疗帕金森病的轴向功能障碍：探索性结果和开放标签扩展。

背景：一项随机试验表明，降低左侧丘脑下刺激幅度可改善轴功能障碍：一项随机试验表明，降低左侧丘脑下刺激振幅可改善轴向功能障碍：探索开放标签耐受性以及试验结果与不对称数据之间的关联：我们收集了接受开放标签侧向设置治疗≥3个月的试验参与者的不良事件。我们探讨了试验结果、刺激位置和运动不对称之间的关联：结果：14/17 的参与者可以忍受单侧振幅减弱（左侧 = 10，右侧 = 4）。284个左侧和1113个右侧受刺激体素与较快的步速相关，81个左侧和22个右侧受刺激体素与较慢的步速相关。步长较短的对侧振幅降低与轴向 MDS-UPDRS 降低 2.4 分有关。步长较长的对侧振幅降低与 MDS-UPDRS 增加 10 分有关：结论：左侧振幅减小可能比右侧振幅减小更容易耐受。右侧刺激比左侧刺激更能加快步速。步长缩短可能反映了对侧过度刺激。

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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来源期刊

Movement Disorders Clinical Practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

7.50%

发文量

218

期刊介绍： Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)

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