Deep Brain Stimulation最新文献_第2页

Consensus guidelines for infection reduction in deep brain stimulation surgery: A literature review and modified Delphi study 减少深部脑刺激手术感染的共识指南：文献综述和改进的德尔菲研究

Deep Brain Stimulation

Pub Date : 2025-04-04 DOI: 10.1016/j.jdbs.2025.03.001

Samira Pardakhtim , Landon Basner , Alice Sohn , Aiyush Bansal , Katie Krause , Anthony Harris , Peter Nora , Jonathan Carlson , Andrew Ko , Chong Lee , Ryder Gwinn , Tony Wang , Benjamin Grannan , Maria Marsans , Farrokh R. Farrokhi

Background and objectives

Deep brain stimulation (DBS) has proven to be safe and effective in the treatment of certain movement disorders. Although the risk profile is low, surgical site infection (SSI) remains a common complication associated with DBS implantation. Currently, no standardized guidelines exist to minimize the risk of infection specific to DBS, and wide variability exists in the interventions used to limit SSI. This study aims to develop the first consensus-based guidelines to reduce the risk of infection in DBS implantation.

Methods

The Delphi technique was employed to establish best practices for perioperative care. A comprehensive literature review on methods to decrease SSI in DBS implantation was completed and shared with all practicing neurosurgeons in Washington state who perform adult DBS implantation. Based on the findings, two web-based surveys were developed and subsequently administered to the participants to discern the importance of specific SSI prevention methods in their practices.

Results

Nine neurosurgeons participated in the study. In the first round, the expert panel indicated interventions used in their practice. This yielded 18 items with high consensus, four items with moderate consensus, and zero items with no consensus. After a live expert panel discussion, the second survey resulted in five items with high consensus: preoperative chlorhexidine gluconate 4.0 % (CHG) showers, hemoglobin A1C target < 7.0, holding immunosuppressive medications, use of a linear incision, and postoperative wound checks.

Conclusion

This study presents the first consensus-based guidelines for infection prevention in DBS implantation, providing valuable recommendations that may help decrease infection rates and standardize practices.

背景与目的脑深部电刺激（DBS）治疗某些运动障碍已被证明是安全有效的。虽然风险较低，但手术部位感染（SSI）仍然是DBS植入相关的常见并发症。目前，没有标准化的指南来最小化DBS特有的感染风险，并且用于限制SSI的干预措施存在很大的差异。本研究旨在制定第一个基于共识的指南，以降低DBS植入的感染风险。方法采用德尔菲法建立围手术期护理的最佳规范。完成了一项关于降低DBS植入中SSI方法的全面文献综述，并与华盛顿州所有实施成人DBS植入的执业神经外科医生分享。基于这些发现，研究人员开展了两项基于网络的调查，并随后对参与者进行了调查，以辨别特定的SSI预防方法在其实践中的重要性。结果9名神经外科医生参与了研究。在第一轮中，专家小组指出了他们在实践中使用的干预措施。结果显示，协商一致度高的项目有18个，协商一致度一般的项目有4个，没有协商一致度的项目为0个。在现场专家小组讨论后，第二次调查得出了五个高度一致的项目：术前葡萄糖酸氯己定4.0 % （CHG）冲洗，血红蛋白A1C目标<； 7.0，持有免疫抑制药物，使用线性切口和术后伤口检查。结论本研究首次提出了基于共识的DBS植入感染预防指南，为降低感染率和规范操作提供了有价值的建议。

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引用次数: 0

Effectiveness of DBS as a treatment for Alzheimer’s disease: Meta-analysis DBS治疗阿尔茨海默病的有效性：荟萃分析

Deep Brain Stimulation

Pub Date : 2025-01-26 DOI: 10.1016/j.jdbs.2025.01.001

Julia Scaramal Mello , Gabriela Ilias Bechara , Paulo Henrique Pires de Aguiar

Introduction

Alzheimer's disease (AD) currently lacks a successful treatment despite being one of the most costly forms of dementia. Deep brain stimulation (DBS) has been used for over three decades as a key treatment for diseases such as Parkinson's due to the neuromodulation achieved by targeting specific brain areas. The hypothesis shows that DBS can modify pathological pathways by modulating local neuronal activity. Consequently, some studies have investigated the effectiveness of DBS as a treatment for Alzheimer's disease. The goal is to perform a systematic review with meta-analysis to determine whether DBS is effective as a treatment for Alzheimer's disease based on the available literature.

Methods

The search was conducted in PubMed, Cochrane, and EMBASE using the terms "DBS" AND "Alzheimer's disease." Articles were included if they met the eligibility criteria: they had to have been published within the last 13 years, be written in English, and discuss both DBS and Alzheimer's disease. Case reports and animal studies were excluded.

Results

8 articles were included after an independent review by 2 reviewers. Data extraction and analysis indicated that patients with mild AD showed less worsening on the ADAS-cog (Alzheimer's Disease Assessment Scale-cognitive subscale) following DBS. The most studied DBS targets were the fornix, followed by the nucleus basalis of Meynert and the ventral capsule/ventral striatum. Additionally, some studies reported improved local metabolism as shown by PET imaging. For the meta-analysis, the change from baseline for the ADAS-Cog scale shows no significant difference in correlation values (5.28 scores) and the studies exhibit heterogeneity. Regarding the MMSE scale, the analysis revealed was - 1.0 (95 % CI − 2.54 to 0.53; I² = 0 %), indicating that DBS, over one year of stimulation, delayed the progression of Alzheimer’s disease on that scale.

Conclusion

Preliminary findings suggest that DBS may be effective in treating AD, but more homogenous studies must be conducted to confirm its effectiveness.

尽管阿尔茨海默病（AD）是最昂贵的痴呆症之一，但目前尚无成功的治疗方法。脑深部刺激（DBS）作为帕金森病等疾病的关键治疗方法已经使用了30多年，这是由于通过针对特定的大脑区域实现神经调节。该假说表明DBS可以通过调节局部神经元活动来改变病理通路。因此，一些研究调查了DBS作为治疗阿尔茨海默病的有效性。目的是通过荟萃分析进行系统评价，以确定DBS是否有效治疗阿尔茨海默病。方法在PubMed， Cochrane和EMBASE中使用“DBS”和“阿尔茨海默病”进行搜索。符合资格标准的文章被纳入：它们必须在过去13年内发表，用英语写作，并且讨论脑起搏器和阿尔茨海默病。排除病例报告和动物研究。结果8篇文献经2位审稿人独立评审后纳入。数据提取和分析表明，轻度AD患者在DBS后ADAS-cog（阿尔茨海默病评估量表-认知亚量表）的恶化程度较轻。研究最多的DBS靶点是穹窿，其次是Meynert基底核和腹侧被膜/腹侧纹状体。此外，一些研究报道PET成像显示局部代谢改善。对于meta分析，ADAS-Cog量表从基线的变化显示相关值无显著差异（5.28分），研究表现出异质性。关于MMSE量表，分析显示为- 1.0(95 % CI - 2.54至0.53；I²= 0 %)，表明在一年的刺激下，DBS在该尺度上延缓了阿尔茨海默病的进展。结论初步结果提示DBS治疗AD可能有效，但仍需更多的同质性研究来证实其有效性。

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引用次数: 0

The responses of subthalamic beta oscillations during voluntary movement in patients with Parkinson’s disease 帕金森病患者自主运动时丘脑下β振荡的反应

Deep Brain Stimulation

Pub Date : 2024-12-09 DOI: 10.1016/j.jdbs.2024.12.003

Chun-Hwei Tai , Sheng-Che Chou , Yen-Chen Lin , Ruey-Meei Wu , Chia-Jung Hsieh , Sheng-Hong Tseng

The purpose of research

We researched the beta power and other electrophysiological markers alterations during voluntary movement in Parkinson’s disease (PD) patients, in order to enhance the use of beta oscillations as a biomarker for currently developing closed-loop DBS (CL-DBS) system.

Methods

We recruited 24 patients with PD and recorded 120 sites in the subthalamic nucleus (STN) during micro-recording sessions during DBS implantation surgery. Both local field potentials (LFP) and single-units activities (SUA) were recorded concomitantly at one site during three consecutive phases: rest phase, voluntary movement phase, and post-movement rest phase. The electrophysiological data are then extracted and analyzed off-line to compare the alterations of these biomarkers during voluntary movement of the PD patients.

Results

Significant increases (17.53 % increase from baseline) in the beta oscillation power during voluntary movement (n = 208, p < 0.0001) was revealed. There was also an increase (6.79 % increase from baseline) in gamma power during voluntary movement (n = 208, p < 0.0001). Besides, there were also concomitant changes in the subthalamic spike rate and burst firing during voluntary movement.

Conclusions

The findings of alterations in beta and gamma oscillations power during voluntary movement of the PD patients will leverage the usefulness and effectiveness of these biomarkers for CL-DBS system.

研究目的研究帕金森病（PD）患者在自主运动过程中β功率和其他电生理标志物的变化，以增强β振荡作为生物标志物在目前正在开发的闭环DBS （CL-DBS）系统中的应用。方法我们招募了24例PD患者，在DBS植入手术中记录了120个丘脑下核（STN）的微记录。局部场电位（LFP）和单单元活动（SUA）在一个部位连续记录三个阶段：休息期、自主运动期和运动后休息期。然后提取电生理数据并离线分析，以比较PD患者在自主运动期间这些生物标志物的变化。结果自主运动时β振荡功率显著增加（比基线增加17.53 %）（n = 208,p <； 0.0001）。自发运动时的伽马能量也增加了（比基线增加了6.79 %）（n = 208,p <； 0.0001）。此外，在自主运动时，丘脑下突刺率和爆发放电也随之发生变化。结论PD患者在自主运动过程中β和γ振荡功率的改变将利用这些生物标志物对CL-DBS系统的有用性和有效性。

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引用次数: 0

Editorial for special issue of Deep Brain Stimulation 《深部脑刺激》特刊社论

Deep Brain Stimulation

Pub Date : 2024-12-06 DOI: 10.1016/j.jdbs.2024.12.001

Cihan Isler, Yildiz Degirmenci, Ersoy Kocabicak

引用次数: 0

Assessing the role of globus pallidus externa in relaying the effect of subthalamic nucleus high-frequency stimulation on the dorsal raphe nucleus 评估外苍白球在传递丘脑底核高频刺激对中缝背核影响中的作用

Deep Brain Stimulation

Pub Date : 2024-12-05 DOI: 10.1016/j.jdbs.2024.12.002

Faisal Alosaimi , Yasin Temel , Ali Jahanshahi

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become a standard surgical treatment option for Parkinson's disease. However, STN-DBS can cause mood-related side effects such as depression. Previous studies have shown that the inhibition of serotonergic cells in the dorsal raphe nucleus (DRN) is a potential cause of depressive-like behavior in rodents treated with STN-DBS. However, the exact anatomical circuitry behind this effect remains elusive. Given the absence of a direct anatomical connection between the STN and the DRN, relay nuclei such as the lateral habenula have been proposed to mediate those effects. Novel cell-type-specific viral tracing methods have recently unveiled a new connection from the STN to the DRN via the globus pallidus externa (GPe). To investigate whether this newly discovered anatomical connection relays the inhibitory effect of STN-DBS to the DRN, we used the designer receptors exclusively activated by the designer drug (DREADD) to inhibit the GPe. We utilized a cell-type-specific calcium indicator in transgenic 5-HT-Cre (ePet-Cre) mice to assess the activity of serotonergic cells in the DRN in STN-DBS mice while the GPe was challenged with DREADD. We observed that chemogenetic modulation of the GPe does not interfere with the suppression of DRN 5-HT neuronal activity caused by STN-DBS. These results suggest that the GPe may not serve as a relay for transmitting the suppressive effects of STN-DBS to the serotonergic neurons in the DRN or the DREADD modulation on the GPe was insufficient to counteract the effects of DBS in our study.

深部脑刺激（DBS）丘脑下核（STN）已成为帕金森病的标准手术治疗方案。然而，STN-DBS会导致与情绪相关的副作用，如抑郁。先前的研究表明，中隔背核（DRN）中血清素能细胞的抑制是STN-DBS治疗啮齿动物抑郁样行为的潜在原因。然而，这种效应背后的确切解剖电路仍然难以捉摸。考虑到STN和DRN之间没有直接的解剖联系，中继核如外侧链核被认为介导了这些作用。新的细胞类型特异性病毒追踪方法最近揭示了通过外苍白球（GPe）从STN到DRN的新连接。为了研究这种新发现的解剖联系是否传递了STN-DBS对DRN的抑制作用，我们使用了由设计药物（DREADD）独家激活的设计受体来抑制GPe。我们在转基因5-HT-Cre （ePet-Cre）小鼠中使用细胞类型特异性钙指示剂来评估STN-DBS小鼠GPe被DREADD攻击时DRN中血清素能细胞的活性。我们观察到GPe的化学发生调节不会干扰STN-DBS引起的DRN 5-HT神经元活性的抑制。这些结果表明GPe可能不是将STN-DBS的抑制作用传递给DRN中的5 -羟色胺能神经元的中继，或者在我们的研究中，对GPe的DREADD调节不足以抵消DBS的作用。

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引用次数: 0

Directional deep brain stimulation for cervical dystonia: Outcomes, challenges and future directions 定向脑深部刺激治疗颈肌张力障碍：成果、挑战和未来方向

Deep Brain Stimulation

Pub Date : 2024-11-20 DOI: 10.1016/j.jdbs.2024.11.002

Luke Andrews , Ahmad M.S. Ali , Mohammed Elmolla , Simon S. Keller , Maneesh Bhojak , Jibril Osman-Farah , Antonella Macerollo

Background

Cervical dystonia is a movement disorder marked by involuntary head and neck muscle contractions. Deep brain stimulation (DBS) targeting the globus pallidus internus (GPi) is a recognised treatment, with directional DBS—enabling current steering—gaining traction in movement disorder management.

Objective

This study assessed clinical outcomes in cervical dystonia patients treated with directional DBS at our centre, compared to a matched group receiving conventional DBS, and examined challenges and research directions in directional DBS for dystonia.

Methods

Eleven patients with adult-onset isolated cervical dystonia received bilateral GPi stimulation with directional DBS systems, compared to a demographically matched cohort with conventional systems. Clinical outcomes and stimulation parameters were recorded at the latest follow-up, and electrode positioning was analysed using patient-specific volumes of tissue activated (VTA).

Results

Directional DBS significantly improved dystonia severity, pain, disability, and quality of life (p < 0.001), with no significant differences versus conventional DBS. Five patients utilised at least one directional electrode; six were set to bilateral “ring-mode” stimulation. Group VTA for directional DBS was positioned more medial and anterior than ring-mode or conventional DBS. Side effects were less frequent in directional DBS (20 %) than in ring-mode (83 %) or conventional DBS (36 %).

Conclusion

Directional DBS showed efficacy comparable to conventional DBS in managing cervical dystonia, with fewer side effects. Despite these benefits, its application in dystonia remains limited compared to other movement disorders, such as Parkinson’s disease and essential tremor, though advances in image-guided programming and biomarker discovery could support wider use in dystonia management.

背景颈肌张力障碍是一种运动障碍，其特征是头颈部肌肉不自主收缩。本研究评估了在本中心接受定向 DBS 治疗的颈性肌张力障碍患者的临床疗效，并与接受传统 DBS 治疗的匹配组进行了比较，同时探讨了定向 DBS 治疗肌张力障碍的挑战和研究方向。方法11名成年孤立性颈肌张力障碍患者接受了定向DBS系统的双侧GPi刺激，并与接受传统系统治疗的人口统计学匹配组进行了比较。结果定向 DBS 显著改善了肌张力障碍的严重程度、疼痛、残疾和生活质量（p < 0.001），与传统 DBS 相比无显著差异。五名患者至少使用了一个定向电极；六名患者接受了双侧 "环模式 "刺激。与环模式或传统 DBS 相比，定向 DBS 的组 VTA 位置更偏内侧和前方。与环形模式（83%）或传统 DBS（36%）相比，定向 DBS 的副作用较少（20%）。尽管有这些优点，但与帕金森病和本质性震颤等其他运动障碍相比，定向 DBS 在肌张力障碍中的应用仍然有限，不过图像引导编程和生物标记物发现方面的进步可支持其在肌张力障碍治疗中的更广泛应用。

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引用次数: 0

Read my lips: Clear versus standard masks during awake deep brain stimulation surgery – A randomized clinical trial 读我的唇语清醒状态下进行深部脑刺激手术时使用透明面罩还是标准面罩--随机临床试验

Deep Brain Stimulation

Pub Date : 2024-11-13 DOI: 10.1016/j.jdbs.2024.11.001

Chesney S. Oravec , Rebecca L. Calafiore , Sidish Venkataraman , Robert K. Townsend , Jacob Brendle , Muneera Kapadia , Carol A. Kittel , Mustafa S. Siddiqui , Adrian W. Laxton , Stephen B. Tatter , Amber Kimball-Hsu , Wesley Hsu

Background

We sought to determine if using clear masks in the operating room improves communication for patients undergoing awake deep brain stimulation (DBS) surgery.

Methods

This randomized, controlled study involved patients undergoing awake DBS receiving communication from the neurologist wearing a covered or clear mask for the intraoperative assessment, using a block randomization schedule. Adult patients (>18) undergoing DBS surgery between November 2021 and July 2023 were evaluated for inclusion. The primary outcome was a dichotomized response to the first question of a 10-question survey: “Did this provider explain things in a way that was easy to understand?”, answered using a Likert scale of 1–4. Secondary outcomes included differences in the responses to the remaining questions.

Results

104 patients were assessed for eligibility, 72 were enrolled, and 65 completed all questionnaires. More males than females (72.3 % versus 27.7 %) were enrolled, and most patients (64 %) underwent DBS for treatment of Parkinson’s disease. The primary outcome analysis showed 93.5 % positive response in the clear mask group compared to 85.3 % in the covered mask group (p = 0.502). There were no infections within 30 days or study-related adverse events in either population.

Discussion

This randomized controlled trial demonstrates that the use of clear masks in the setting of awake brain surgery has no difference on patient perception of communication compared to covered masks. There were no infections or mask-related adverse events. This suggests that clear masks are a safe and effective alternative to traditional masks in the operating room.

背景我们试图确定在手术室使用透明面罩是否能改善清醒状态下接受脑深部刺激（DBS）手术的患者的交流。方法这项随机对照研究采用分块随机化安排，让接受清醒状态下 DBS 手术的患者在术中评估时戴上有盖或透明面罩，接受神经科医生的交流。2021年11月至2023年7月期间接受DBS手术的成年患者（18岁）均被纳入评估范围。主要结果是对 10 个问题调查中第一个问题的二分法回答："该医疗服务提供者的解释是否通俗易懂？"，采用 1-4 级李克特量表进行回答。次要结果包括对其余问题回答的差异。结果104名患者接受了资格评估，72人注册，65人完成了所有问卷。入选患者中男性多于女性（72.3% 对 27.7%），大多数患者（64%）因帕金森病接受了 DBS 治疗。主要结果分析显示，透明面罩组的阳性反应率为 93.5%，而覆盖面罩组为 85.3%（P = 0.502）。讨论这项随机对照试验表明，在脑部清醒手术中使用透明喉罩与覆盖式喉罩相比，患者对交流的感知没有差异。没有发生感染或与口罩相关的不良事件。这表明透明口罩是手术室中传统口罩的一种安全有效的替代品。

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引用次数: 0

The correlation between motor improvement and disability in activities of daily living after DBS in Parkinson’s disease, tremor and dystonia 帕金森病、震颤和肌张力障碍患者接受 DBS 治疗后运动改善与日常生活活动障碍之间的相关性

Deep Brain Stimulation

Pub Date : 2024-10-15 DOI: 10.1016/j.jdbs.2024.10.002

Yarit Wiggerts , Annabel van der Weide , Evan Markidis , Joke M. Dijk , Vincent J.J. Odekerken , Maarten Bot , Pepijn van den Munckhof , P. Rick Schuurman , Rob M.A. de Bie , Martijn Beudel

Background

Deep brain stimulation (DBS) for Parkinson’s disease (PD), essential tremor (ET), and dystonia is a well-established treatment option. The correlation between motor symptom improvement and effect on disability is inconclusive.

Objectives

To assess the correlation between DBS-induced improvements of motor symptoms and disability for PD, ET and dystonia.

Methods

Disability and motor scores were obtained before and six to twelve months after surgery for 324 PD, 35 ET and 40 dystonia patients.

Results

There was a modest and significant correlation for PD (Rho=0.284, p < 0.001), a substantial and significant correlation for ET (Rho=0.542, p < 0.001) and no correlation for dystonia (Rho=0.238, p = 0.138) between motor score and disability improvement.

Conclusions

The effect of DBS on motor symptoms and disability is not uniformly for dystonia. Possible reasons for this are that the scales used might not be responsive or other symptoms than motor symptoms might have a greater impact on disability.

背景脑深部刺激（DBS）治疗帕金森病（PD）、本质性震颤（ET）和肌张力障碍是一种行之有效的治疗方法。方法对 324 名帕金森病患者、35 名 ET 患者和 40 名肌张力障碍患者进行术前和术后 6-12 个月的残疾和运动评分。结果肌张力障碍患者的运动评分与残疾改善之间存在适度且显著的相关性（Rho=0.284，p <0.001），ET患者的运动评分与残疾改善之间存在显著的相关性（Rho=0.542，p <0.001），而肌张力障碍患者的运动评分与残疾改善之间没有相关性（Rho=0.238，p = 0.138）。结论DBS对肌张力障碍患者运动症状和残疾程度的影响并不一致，可能的原因是所使用的量表可能反应不灵敏，或者除运动症状外，其他症状对残疾程度的影响更大。

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引用次数: 0

Deep brain stimulation in a patient with dystonic tremor with a novel familial VPS16 gene mutation 深部脑刺激治疗患有肌张力震颤并伴有新型家族性 VPS16 基因突变的患者

Deep Brain Stimulation

Pub Date : 2024-10-05 DOI: 10.1016/j.jdbs.2024.10.001

Chiara van der Kuy , Pieter L. Kubben , Linda Ackermans , Mayke Oosterloo , Mark L. Kuijf , Marcus L.F. Janssen

Dystonia is a neurological disorder characterized by intermittent muscle contractions or abnormal movements. The pathophysiology and pathogenetic variations are increasingly better understood, but their translation into appropriate treatment is still largely lacking. We present a case of a woman suffering from a dystonic tremor of the upper limbs and head. Both the patient treated with DBS and her sister carry a novel mutation in the VPS16 gene. Treatment proved to be successful through deep brain stimulation targeting the ventral intermediate nucleus of the thalamus.

肌张力障碍是一种以间歇性肌肉收缩或异常运动为特征的神经系统疾病。人们对肌张力障碍的病理生理学和病因变异有了越来越深入的了解，但在很大程度上仍缺乏将其转化为适当治疗的方法。我们介绍了一例患有上肢和头部肌张力震颤的女性患者。接受 DBS 治疗的患者和她的姐姐都携带 VPS16 基因的新型突变。通过针对丘脑腹侧中间核的脑深部刺激，治疗取得了成功。

引用次数: 0

Cervical dystonia patients with psychiatric classification: Despite dystonia improvement less improvement in other domains after DBS surgery 颈肌张力障碍患者的精神分类：尽管肌张力障碍在 DBS 手术后有所改善，但其他方面的改善较少

Deep Brain Stimulation

Pub Date : 2024-09-30 DOI: 10.1016/j.jdbs.2024.09.001

Annabel van der Weide , Anjum Aarifa Khanom , Yarit Wiggerts , Yasmin Namavar , Joke Dijk , Maarten Bot , Pepijn van den Munckhof , Rick Schuurman , Rob M.A. de Bie , Jibril Osman Farah , Antonella Macerollo , Martijn Beudel

Background

Patient satisfaction of deep brain stimulation (DBS) for cervical dystonia (CD) is heterogeneous. A high prevalence of psychiatric disorders in patients with CD is well-established. The presence of psychiatric classification in CD may affect the outcomes of DBS treatment.

Methods

A cohort of 49 patients with CD and GPi-DBS was retrospectively studied in two centers. Psychiatric history was obtained from patient records. Pre- and post-operative Toronto Western Spasmodic Torticollis Rating Scores (TWSTRS, range 0–85) were compared between patients with and those without psychiatric classification. The TWSTRS disability and pain sub-scores were combined to evaluate non-motor improvement. The severity sub-score was used to assess motor improvement.

Results

Twenty (40.8 %) patients had a psychiatric classification, predominantly major depressive disorder and anxiety disorders. Following DBS treatment, the overall mean (± SD) improvement on the TWSTRS was 38.0 ± 29.2 %. Significantly, patients with a psychiatric classification experienced less improvement in the non-motor domain than the patients without a psychiatric classification (29.1 ± SD 38.2 % [range −41.7 to 96.6 %] vs. 51.9 ± 33.6 % [range −8.6 to 100.0 %]; p = 0.02).

Conclusion

Our findings indicate that CD patients with psychiatric classifications experience less non-motor improvement following DBS. Psychiatric comorbidities could influence the lacking experience of successful DBS treatment despite good motor outcome. Therefore, it is important to establish these comorbidities in CD patients undergoing DBS with respect to expectation management and treatment if necessary.

背景深部脑刺激（DBS）治疗颈性肌张力障碍（CD）的患者满意度参差不齐。CD 患者中精神障碍的高患病率已得到证实。方法对两个中心的 49 名 CD 和 GPi-DBS 患者进行了回顾性研究。从患者病历中获取精神病史。比较了有精神病分类和无精神病分类患者的术前和术后多伦多西方痉挛性皮肌痉挛评分（TWSTRS，范围 0-85）。将 TWSTRS 残疾和疼痛子分数合并，以评估非运动改善情况。结果20 名（40.8%）患者有精神病分类，主要是重度抑郁症和焦虑症。接受 DBS 治疗后，TWSTRS 的总体平均（± SD）改善率为 38.0 ± 29.2%。值得注意的是，与无精神分类的患者相比，有精神分类的患者在非运动领域的改善较少（29.1 ± SD 38.2 % [范围-41.7至96.6 %] vs. 51.9 ± 33.6 % [范围-8.6至100.0 %]; p = 0.02）。我们的研究结果表明，患有精神疾病的 CD 患者在接受 DBS 治疗后，非运动功能的改善较少。尽管运动功能改善良好，但精神疾病合并症可能会影响 DBS 治疗的成功率。因此，必须确定接受 DBS 治疗的 CD 患者是否有这些合并症，以便在必要时进行预期管理和治疗。

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引用次数: 0