使用伽马振荡的适应性脑深部刺激治疗帕金森病的持续临床效益：一个病例报告。

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY Movement Disorders Pub Date : 2024-12-04 DOI:10.1002/mds.30076

Stephanie Cernera PhD, Carina R. Oehrn MD, PhD, Lauren H. Hammer MD, PhD, Maria Shcherbakova BS, Jiaang Yao MS, Amelia Hahn BS, Sarah Wang PhD, Jill L. Ostrem MD, Simon Little MBBS, PhD, Philip A. Starr MD, PhD

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引用次数: 0

摘要

背景：适应性深部脑刺激（aDBS）可根据患者需要动态调整刺激参数。我们最近在一项为期2个月的试验中发现，在日常生活中，利用侵入性神经信号进行反馈控制的慢性aDBS优于常规DBS （cDBS）。aDBS在较长时期内的稳定性仍不清楚。目的：评估aDBS对1例帕金森病患者8个月以上运动症状和生活质量的影响。方法：我们使用刺激引起的皮质伽马振荡作为丘脑下核aDBS的控制信号，并使用运动日记评分、生活质量量表和可穿戴指标量化其益处。结果：我们发现，与基线cDBS相比，aDBS在运动迟缓和生活质量方面具有优越和一致的益处。结论：与临床优化的cDBS相比，aDBS可以实现长期、稳定的改善。神经信号保持稳定，aDBS参数在较长时间内保持适当。©2024国际帕金森和运动障碍学会。

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Sustained Clinical Benefit of Adaptive Deep Brain Stimulation in Parkinson's Disease Using Gamma Oscillations: A Case Report

Background

Adaptive deep brain stimulation (aDBS) dynamically adjusts stimulation parameters according to patient needs. We recently showed that chronic aDBS utilizing invasive neural signals for feedback control is superior to conventional DBS (cDBS) during normal daily life in a 2-month trial. The stability of aDBS over longer periods remains unclear.

Objectives

To assess the effects of aDBS on motor symptoms and quality of life (QoL) in one individual with Parkinson's disease over 8 months.

Methods

We used stimulation-entrained cortical gamma oscillations as a control signal for aDBS in the subthalamic nucleus and quantified benefits using motor diary ratings, QoL scales, and wearable metrics.

Results

We found that aDBS delivered superior and consistent benefits compared with baseline cDBS in measures of bradykinesia and QoL.

Conclusions

aDBS can achieve prolonged, stable improvement over clinically optimized cDBS. The neural signal remains stable, and aDBS parameters remain appropriate over extended periods. © 2024 International Parkinson and Movement Disorder Society.

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.