丘脑底核脑深部电刺激术治疗伴有异动的帕金森病的疗效分析

王宽; 詹彦; 蒋理; 黄加尚; 向怡; 石全红; 谢延风

doi:10.16016/j.1000-5404.202007251

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丘脑底核脑深部电刺激术治疗伴有异动的帕金森病的疗效分析

临床医学 | 更新时间：2026-01-09

- 丘脑底核脑深部电刺激术治疗伴有异动的帕金森病的疗效分析
- Efficacy of subthalamic deep brain stimulation for levodopa-induced dyskinesia in patients with Parkinson's disease: retrospective analysis of 12 cases
- 第三军医大学学报 2020年42卷第24期页码：2426-2432
- 作者机构：
  
  400016 重庆，重庆医科大学附属第一医院神经外科
- 作者简介：
  
  [詹彦，E-mail: zhan.yan2@hotmail.comZHAN Yan, E-mail: zhan.yan2@hotmail.com
- 基金信息：
- DOI：10.16016/j.1000-5404.202007251
  中图分类号： R651.1;R742.5
- 收稿：2020-07-31，
  
  修回：2020-10-07，
  
  纸质出版：2020-12-30
- 稿件说明：
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王宽, 詹彦, 蒋理, 等. 丘脑底核脑深部电刺激术治疗伴有异动的帕金森病的疗效分析[J]. 第三军医大学学报, 2020,42(24):2426-2432.

Kuan WANG, Yan ZHAN, Li JIANG, et al. Efficacy of subthalamic deep brain stimulation for levodopa-induced dyskinesia in patients with Parkinson's disease: retrospective analysis of 12 cases[J]. Journal of Third Military Medical University, 2020, 42(24): 2426-2432.
王宽, 詹彦, 蒋理, 等. 丘脑底核脑深部电刺激术治疗伴有异动的帕金森病的疗效分析[J]. 第三军医大学学报, 2020,42(24):2426-2432. DOI： 10.16016/j.1000-5404.202007251.

Kuan WANG, Yan ZHAN, Li JIANG, et al. Efficacy of subthalamic deep brain stimulation for levodopa-induced dyskinesia in patients with Parkinson's disease: retrospective analysis of 12 cases[J]. Journal of Third Military Medical University, 2020, 42(24): 2426-2432. DOI： 10.16016/j.1000-5404.202007251.

摘要

目的

评估丘脑底核(subthalamic nucleus，STN)脑深部电刺激术(deep brain stimulation，DBS)对伴有异动的帕金森病的治疗效果，并探讨STN-DBS治疗异动症状(levodopa-induced dyskinesia，LID)的可行性及其可能机制。

方法

对2016年3月至2019年12月于本中心行STN-DBS治疗的帕金森病患者进行回顾性分析。术前及术后6个月随访均使用统一帕金森病评定量表(UPDRS)Ⅲ部分、Ⅳ部分和异动评分(UPDRS Ⅳ部分第32~34项)以及左旋多巴等效剂量(levodopa equivalent daily dose，LEDD)评估疗效。

结果

STN-DBS术后6个月，最终所纳入的12例患者异动症状均明显改善，UPDRS Ⅳ评分和异动评分术后改善率分别为(45.91±13.01)%和(61.96±22.03)%。术后6个月，有2例患者左旋多巴等效剂量维持术前剂量，其余10例患者均减少了药物剂量，最高者减药率达72.00%，平均43.58%。同时，所有患者运动症状也得到显著改善，UPDRS Ⅲ评分关期改善率为(68.14±9.51)%。

结论

STN-DBS能明显改善帕金森患者的异动症状，其不仅能通过减药控制异动症，还能对异动症有直接抑制作用。

Abstract

Objective

To evaluate the clinical effectiveness of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in treatment of levodopa-induced dyskinesia (LID) in patients with Parkinson's disease (PD)

and to explore the feasibility and the possible underlying mechanism of the treatment.

Methods

A retrospective review was conducted on all the PD patients who underwent STN-DBS in our department from March 2016 to December 2019. Unified Parkinson's Disease Rating Scale (UPDRS) part Ⅲ and part Ⅳ

dyskinesia subscore (items 32 to 34 of UPDRS part Ⅳ) and the levodopa equivalent daily dose (LEDD)

which were used to evaluate the improvement of the symptoms before and in 6 months after operation.

Results

In 6 months after STN-DBS

the LID symptoms of the 12 patients finally enrolled were significantly improved

with the improvement rates of UPDRS Ⅳ score and dyskinesia subscore of (45.91±13.01)% and (61.96±22.03)%

respectively. Among them

the LEDD was maintained in 2 patients

and reduced in the other 10 patients

with the averagely reduced rate of 43.58%

and the highest rate of 72.00%. Meanwhile

the motor symptoms of all patients were also significantly improved

and the improvement rate of UPDRS Ⅲ score was (68.14±9.51)%.

Conclusion

STN-DBS significantly improves dyskinesia symptom of PD patients. Its anti-dyskinesia effect may be not only related to reduction of drug dose

but also to direct inhibition of LID.

关键词

Keywords

references

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