交叉电脉冲在帕金森病DBS后程控中的应用  

Application of interleaving stimulation in patients with Parkinson’s disease after deep brain stimulation

作　　者：邵钰阳 杨鑫 聂盼 张修民 付锴[1] 熊文平[1] 柳雯 张继波[1] 陈劲草[1] 张捷[1] SHAO Yu-yang;YANG Xin;NIE Pan;ZHANG Xiu-min;FU Kai;XIONG Wen-ping;LIU Wen;ZHANG Ji-bo;CHEN Jin-cao;ZHANG Jie(Department of Neurosurgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院神经外科/功能神经外科中心,武汉430071

出　　处：《中国临床神经外科杂志》2022年第11期889-891,952,共4页Chinese Journal of Clinical Neurosurgery

基　　金：科技部国家重点研发计划(2016YFC0105900)。

摘　　要：目的探讨交叉电脉冲(ILS)在帕金森病(PD)脑深部电刺激术(DBS)后传统刺激方式疗效不佳病人中的应用效果。方法回顾性分析2018年2月至2021年10月丘脑底核(STN)-DBS治疗的12例PD的临床资料。12例DBS后应用传统刺激方式疗效不佳,使用ILS(时间>6个月)。使用ILS后随访6~12个月,采用统一帕金森病生活量表(UPDRSⅡ)评分、运动量表(UPDRSⅢ)评分、异动症量表(UPDRSⅣ-A)评分评估疗效及左旋多巴等效日剂量(LEDD)评价药物使用情况。结果与ILS前(药物关期)相比,使用ILS后(药物关期)UPDRS-Ⅱ评分、UPDRSⅣ-A评分、UPDRS-Ⅲ评分总分均明显改善(P<0.05),LEDD无明显变化(P>0.05)。结论PD病人STN-DBS后,在传统刺激模式症状改善不佳或出现刺激副反应时,ILS可明显改善PD症状、减轻刺激相关副反应。Objective To explore the application value of interleaving stimulation(ILS)in the postoperative programming of patients with Parkinson’s disease(PD)after deep brain stimulation(DBS).Methods The clinical data of 12 patients with PD who received subthalamic nucleus(STN)DBS in Zhongnan Hospital of Wuhan University from February 2018 to October 2021 were retrospectively analyzed.Traditional stimulation was ineffective after DBS,and ILS was then used for more than 6 months.The clinical efficacy was evaluated by the Unified Parkinson’s Disease Living Scale(UPDRSⅡ),Exercise Scale(UPDRSⅢ)and UPDRSⅣ-A and levodopa equivalent daily dose(LEDD)was used to evaluate the drug use 6~12 months after ILS.Results The UPDRSⅡscore,the UPDRSⅢscore and the UPDRSⅣ-A score were significantly improved after ILS(P<0.05),and the LEDD did not significantly change(P>0.05).Conclusions For PD patients after STN-DBS,ILS can significantly improve the symptoms and reduce the stimulation-related side reactions when the traditional stimulation was ineffective after DBS.

关 键 词：帕金森病 丘脑底核 脑深部电刺激术 交叉电脉冲 术后程控 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]