帕金森病脑深部电刺激术中运动迟缓量化测评初探  

Quantitative measurements for bradykinesia evaluation during deep brain stimulation surgery in patients of Parkinson′s disease:an exploratory study

作　　者：吴静超[1] 于宁波 于洋[4] 李海涛[1] 吴璠 杨宇辰 林家能 韩建达 梁思泉[1] Wu Jingchao;Yu Ningbo;Yu Yang;Li Haitao;Wu Fan;Yang Yuchen;Lin Jianeng;Han Jianda;Liang Siquan(Department of Neurosurgery,Tianjin Huanhu Hospital,Tianjin 300222,China;College of Artificial Intelligence,Nankai University,Tianjin 300071,China;Tianjin Key Laboratory of Intelligent Robotics,Nankai University,Tianjin 300071,China;Department of Neurological Rehabilitation,Tianjin Huanhu Hospital,Tianjin 300222,China)

机构地区：[1]天津市环湖医院神经外科,天津300222 [2]南开大学人工智能学院,天津300071 [3]天津市智能机器人技术重点实验室,天津300071 [4]天津市环湖医院康复医学科,天津300222

出　　处：《中华神经外科杂志》2022年第11期1114-1119,共6页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金(U1913208,61873135);天津市卫生健康科技项目(ZD20017,KJ20054)。

摘　　要：目的初步探讨应用厉动手势体感控制器(LMC)进行帕金森病(PD)脑深部电刺激(DBS)术中运动迟缓量化测评的可行性。方法前瞻性纳入2020年5月至2021年3月天津市环湖医院神经外科采用双侧DBS治疗的14例PD患者。分别于术前和术中DBS电极植入后应用LMC采集手指拍打运动、手掌运动、轮替运动的数据;每个动作重复10次,提取完整动作周期内的速度(V)、频率(F)和幅度峰值(A),并计算其平均值(、和)、变化趋势(ΔV、ΔF和ΔA)以及变异系数(V_(CV)、FCV和A_(CV))。LMC采集数据的同时由医生进行运动障碍学会帕金森病统一评定量表第三部分(MDS-UPDRS-Ⅲ)3.4~3.6项目评分。分别比较术前与术中3个任务中评估的9项指标,并将9项指标与对应的MDS-UPDRS-Ⅲ项目评分进行相关性分析。结果14例患者均完成动作采集,纳入统计的152个动作中,术前、术中手指拍打运动各23组、手掌运动各27组、轮替运动各26组。术中患者手指拍打运动、V_(CV)、、A_(CV),手掌运动的、ΔA、A_(CV),轮替动作的、V_(CV)、、ΔA、A_(CV)均较术前改善,差异均具有统计学意义(均P<0.05)。患者手指拍打运动的、V_(CV)、FCV、、A_(CV),手掌运动的、ΔV、V_(CV)、、FCV、ΔA、A_(CV),轮替运动的、ΔV、V_(CV)、FCV、、ΔA、A_(CV)均与MDS-UPDRS-Ⅲ对应评分具有相关性(均P<0.05)。结论初步研究发现,LMC可应用于DBS术中进行手指拍打运动、手掌运动、轮替运动的量化测评。Objective To explore the feasibility of quantitative assessment of intraoperative bradykinesia using Leap motion Controller(LMC)during deep brain stimulation(DBS)for Parkinson′s disease(PD).Methods A prospective study was conducted on 14 patients with PD treated with bilateral DBS in the Department of Neurosurgery of Tianjin Huanhu Hospital from May 2020 to March 2021.The LMC was used to collect data on the motor tasks of finger tapping(FT),hand opening and closing(OC),hand pronation and supination(PS)before surgery and after implantation of DBS electrodes.Each action was repeated 10 times,the velocity(V),frequency(F),and amplitude peaks(A)over the full action cycle were extracted,and the means(、and),the trend(ΔV、ΔF andΔA)and the coefficient of variation(V_(CV)、FCVand A_(CV))were calculated.The LMC data were collected at the time as the assessment by physicians according to the third part of Movement Disorder Society-Sponsored Revision of the Unified Parkinson′s Disease Rating Scale(MDS-UPDRS-Ⅲ)3.4 to 3.6 items.Nine indicators in the 3 tasks before and during operation were compared respectively,and the correlation analysis was carried out between the 9 indicators and the corresponding MDS-UPDRS-Ⅲitem scores.Results All 14 patients completed the documentation of movements,and the 152 actions including 23 groups of FT,27 groups of OC,and 26 groups of PS were analyzed by statistics.The、V_(CV)、、A_(CV)of FT,、ΔA、A_(CV)of OC,、V_(CV)、、ΔA、A_(CV)of PS in the intraoperative conditions improved compared with preoperative conditions,and the differences were statistically significant(all P<0.05).The、V_(CV)、FCV、、A_(CV)of FT,、ΔV、V_(CV)、、FCV、ΔA、A_(CV)of OC,and、ΔV、V_(CV)、FCV、、ΔA、A_(CV)of PS were all correlated with the MDS-UPDRS-Ⅲcorresponding scores(all P<0.05).Conclusion Preliminary studies have suggested that LMC can be applied to quantitative evaluation of FS,OC and PS during DBS surgery.

关 键 词：帕金森病 深部脑刺激法 症状评估 量化评估 

分 类 号：R651.1[医药卫生—外科学]