晚期帕金森病患者病情持续进展与有效的丘脑下核刺激  

Disease progression continues in patients with advanced Parkinson's disease and effective subthalamic nucleus stimulation

作　　者：Hilker R. Portman A.T. Voges J. 邓剑平 

机构地区：[1]Dr.Department of Neurology, University Hospital, Joseph-Stel-zmann-Strasse 9, 50924 Cologne, Germany

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第12期41-41,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Objectives: Glutamate mediated excitotoxicity of the hyperactive subthalamic nucleus (STN) has been reported to contribute to nigral degeneration in Parkinson’s disease (PD). Deep brain stimulation of the STN (STN DBS), in its role as a highly effective treatment of severe PD motor complications, has been thought to inhibit STN hyperactivity and therefore decrease progression of PD. Methods: In a prospective two centre study, disease progression was determined by means of serial 18F fluorodopa (F-dopa) positron emission tomography (PET) in 30 patients with successful STN DBS over the first 16 (SD 6) months after surgery. Results: Depending on the method of PET data analysis used in the two centres, annual progression rates relative to baseline were 9.5-12.4%in the caudate and 10.7-12.9%in the putamen. Conclusions: This functional imaging study is the first to demonstrate a continuous decline of dopaminergic function in patients with advanced PD under clinically effective bilateral STN stimulation. The rates of progression in patients with STN DBS were within the range of previously reported data from longitudinal imaging studies in PD. Therefore this study could not confirm the neuroprotective properties of DBS in the STN target.Objectives: Glutamate mediated excitotoxicity of the hyperactive subthalamic nucleus (STN) has been reported to contribute to nigral degeneration in Parkinson's disease (PD). Deep brain stimulation of the STN (STN DBS), in its role as a highly effective treatment of severe PD motor complications, has been thought to inhibit STN hyperactivity and therefore decrease progression of PD. Methods: In a prospective two centre study, disease progression was determined by means of serial 18F fluorodopa (F-dopa) positron emission tomography (PET) in 30 patients with successful STN DBS over the first 16 (SD 6) months after surgery. Results: Depending on the method of PET data analysis used in the two centres, annual progression rates relative to baseline were 9.5-12.4%in the caudate and 10.7-12.9%in the putamen. Conclusions: This functional imaging study is the first to demonstrate a continuous decline of dopaminergic function in patients with advanced PD under clinically effective bilateral STN stimulation. The rates of progression in patients with STN DBS were within the range of previously reported data from longitudinal imaging studies in PD. Therefore this study could not confirm the neuroprotective properties of DBS in the STN target.

关 键 词：帕金森病 脑深部刺激 多巴胺能 进展率 黑质 壳核 尾状核 兴奋毒性 成像研究 功能成像 

分 类 号：R742.5[医药卫生—神经病学与精神病学]