可穿戴设备评估帕金森病患者丘脑底核脑深部电刺激术后短期步态变化  

Application of wearable devices in assessing the short-term effect of subthalamic nucleus deep brain stimulation on gait in patients with Parkinson disease

作　　者：何婧[1] 杜危 崔壮[2] 杨玉明[2] 陈海波[1] 苏闻[1] HE Jing;DU Wei;CUI Zhuang(Department of Neurology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院神经内科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [2]北京医院神经外科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中风与神经疾病杂志》2024年第5期459-463,共5页Journal of Apoplexy and Nervous Diseases

基　　金：国家重大疾病多学科合作诊疗能力建设项目——帕金森病精准全程管理项目(bj-2020-153)。

摘　　要：目的应用可穿戴设备评估帕金森病患者丘脑底核脑深部电刺激术后短期的步态变化。方法在未服药/未开机、服药/未开机和未服药/开机3种不同的治疗状态下,让患者佩戴可穿戴传感器完成计时起立行走测试,收集并分析时空运动参数。结果共13例平均病程(8.00±1.38)年的接受双侧丘脑底核脑深部电刺激的帕金森病患者被纳入研究。与未服药/未开机状态相比,脑深部电刺激使患者的起立行走测试总用时由(30.63±17.58)s缩短至(19.50±5.78)s(P=0.003),步长由(39.44±14.34)cm增加至(49.46±13.41)cm(P=0.004)、步速由(0.68±0.27)m/s增加至(0.91±0.25)m/s(P=0.005),躯干前倾最大角度由(-25.32°±10.83°)减少至(-17.32°±12.49°)(P=0.047),躯干后倾最大角度由(-22.03°±11.24°)减少至(-13.16°±12.83°)(P=0.022),差异均有统计学意义。结论在术后短期内,丘脑底核脑深部电刺激可以缩短帕金森病患者起立行走测试用时,显著增加患者步长及步速,减少患者行走过程中躯干前倾角度。Objective To evaluate the short-term effect of subthalamic nucleus deep brain stimulation(STN-DBS)on gait in patients with Parkinson disease(PD)using wearable devices.Methods Patients were required to wear wearable sensors to perform timed up and go test(TUG)in the three different states of medication-off/stimulation-off,medication-on/stimulation-off,medication-off/stimulation-on,and spatiotemporal motion parameters were collected and analyzed.Results A total of 13 PD patients with a mean disease course of(8.00±1.38)years who underwent bilateral STN-DBS were included.Compared with the medication-off/stimulation-off state,STN-DBS shortened the total duration of TUG from(30.63±17.58)seconds to(19.50±5.78)seconds(P=0.003),increased step length from(39.44±14.34)cm to(49.46±13.41)cm(P=0.004),increased step speed from(0.68±0.27)m/s to(0.91±0.25)m/s(P=0.005),reduced the maximum trunk anteversion angle from(-25.32°±10.83°)to(-17.32°±12.49°)(P=0.047),and reduced the maximum trunk retroversion angle from(-22.03°±11.24°)to(-13.16°±12.83°)(P=0.022),all of which were statistically significant.Conclusion Within the short term after surgery,STN-DBS can shorten the total duration of TUG test,increase step length and speed,and reduce trunk anteversion angle during walking.

关 键 词：可穿戴设备 帕金森病 脑深部电刺激 步态 

分 类 号：R742[医药卫生—神经病学与精神病学]