苍白球内侧核脑深部电刺激术对Meige综合征患者运动和非运动功能的影响  

Effect of pallidal deep brain stimulation on motor and non-motor functions in patients with Meige syndrome

作　　者：郑文韬 郝庆沛 刘业祖 丁虎 武广永 张子豪 刘如恩[1] Zheng Wentao;Hao Qingpei;Liu Yezu;Ding Hu;Wu Guangyong;Zhang Zihao;Liu Ruen(Department of Neurosurgery,People's Hospital of Peking University,Beijing 100044,China;Department of Neurosurgery,First Affiliated Hospital of Xiamen University,Xiamen 361003,China)

机构地区：[1]北京大学人民医院神经外科,北京100044 [2]厦门大学附属第一医院神经外科,厦门361003

出　　处：《中华神经医学杂志》2023年第8期801-807,共7页Chinese Journal of Neuromedicine

摘　　要：目的:探讨双侧苍白球内侧核脑深部电刺激术(GPi-DBS)对Meige综合征患者运动症状、生活质量、睡眠质量、神经心理功能和情绪状态的影响。方法:回顾性分析北京大学人民医院神经外科自2019年5月至2021年3月采用双侧GPi-DBS治疗的17例Meige综合征患者临床资料。使用经过验证的标准化量表对患者术前(基线状态)、术后1年和2年时的运动症状、生活质量、睡眠质量、神经心理功能和情绪状态进行评估。结果:术后1年和术后2年时,患者Burke-Fahn-Marsden肌张力障碍评定量表(BFMDRS)运动总评分由术前的(14.4±6.2)分降低至(4.3±2.2)分、(3.5±1.9)分,差异均有统计学意义(P<0.05);BFMDRS残疾总评分由术前的(6.2±4.0)分降低至(2.8±2.0)分、(2.2±1.5)分,差异均有统计学意义(P<0.05)。与术前相比,患者术后1年、术后2年时的36项健康状况调查简表(SF-36)中的生理功能、生理职能、总体健康分项得分均显著提高,差异均有统计学意义(P<0.05)。患者术后1年和术后2年时的睡眠质量、神经心理功能和情绪状态各量表评分与术前相比差异均无统计学意义(P>0.05)。结论:双侧GPi-DBS能有效、安全地改善Meige综合征患者的运动症状并提高生活质量,且对患者的睡眠质量、神经心理功能和情绪状态无不良影响。Objective To investigate the effect of bilateral globus pallidus internus deep brain stimulation(GPi-DBS)on motor performance,quality of life,sleep quality,neuropsychological status,and mood in patients with Meige syndrome.Methods The clinical data of 17 patients with Meige syndrome accepted bilateral GPi-DBS in Department of Neurosurgery,People's Hospital of Peking University from May 2019 to March 2021 were retrospectively analyzed.Established and validated rating scales were used to assess the motor performance,quality of life,sleep quality,neuropsychological status,and mood at baseline,and 1 and 2 years after GPi-DBS.Results Burke-Fahn-Marsden dystonia rating scale(BFMDRS)motor total scores decreased from 14.4±6.2 at baseline to 4.3±2.2 and 3.5±1.9 at 1 and 2 years after GPi-DBS,with significant differences(P<0.05).BFMDRS disability total scores decreased from 6.2±4.0 at baseline to 2.8±2.0 and 2.2±1.5 at 1 and 2 years after GPi-DBS,with significant differences(P<0.05).In 36-item Short-Form Health Survey(SF-36),the scores of physical function,role-physical,general health sub-items at 1 and 2 years after GPi-DBS were significantly higher than those at baseline(P<0.05).No significant differences were noted in scores of sleep quality,neuropsychological function,or mood scales at 1 and 2 years after GPi-DBS compared with those at baseline(P>0.05).Conclusion Bilateral GPi-DBS is effective and safe in Meige syndrome,which can improve dystonic symptom and quality of life without adverse effects on sleep quality,neuropsychological function,or emotional status.

关 键 词：MEIGE综合征 苍白球内侧核 脑深部电刺激术 运动症状 神经心理功能 

分 类 号：R651[医药卫生—外科学]