[1]杨巧钰,罗针,赵小燕,等.尾状核指数对帕金森病脑深部电刺激术疗效的影响[J].中国临床神经外科杂志,2022,27(09):742-744.[doi:10.13798/j.issn.1009-153X.2022.09.007]
 YANG Qiao-yu,LUO Zhen,ZHAO Xiao-yan,et al.Effect of bicaudate index on outcomes of deep brain stimulation for patients with Parkinson's disease[J].,2022,27(09):742-744.[doi:10.13798/j.issn.1009-153X.2022.09.007]
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尾状核指数对帕金森病脑深部电刺激术疗效的影响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年09期
页码:
742-744
栏目:
论著
出版日期:
2022-09-30

文章信息/Info

Title:
Effect of bicaudate index on outcomes of deep brain stimulation for patients with Parkinson's disease
文章编号:
1009-153X(2022)09-0742-03
作者:
杨巧钰罗针赵小燕陈崇毅杨威
610041 成都,四川大学华西医院神经外科(杨巧钰、罗针、赵小燕);610041 成都,四川大学华西医院西藏成办分院神经外科(陈崇毅、杨威)
Author(s):
YANG Qiao-yu1 LUO Zhen1 ZHAO Xiao-yan1 CHEN Chong-yi2 YANG Wei2
1. Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu 610041, China; 2. Department of Neurosurgery, Xizang Chengban Branch, West China Hospital of Sichuan University, Chengdu 610041, China
关键词:
帕金森病脑深部电刺激苍白球内侧部尾状核指数
Keywords:
Parkinson disease Deep brain stimulation Globus pallidus interna Bicaudate nucleus index
分类号:
R742.5;R651.1+1
DOI:
10.13798/j.issn.1009-153X.2022.09.007
文献标志码:
A
摘要:
目的 探讨尾状核指数对帕金森病(PD)双侧苍白球内侧部(GPi)脑深部电刺激术(DBS)疗效的影响。方法 回顾性分析2018年8月至2020年12月双侧GPi-DBS治疗的36例PD的临床资料。术前应用MRI测量尾状核指数、Evans指数及第三脑室宽度。术前、术后6个月应用39项帕金森病问卷(PDQ-39)评分、统一帕金森病评定量表Ⅲ(UPDRS-Ⅲ)评分、左旋多巴等效日剂量(LEDD)评估疗效。根据术后6个月UPDRS-Ⅲ评分分为改善组(n=26)与恶化组(n=10)。结果 术后6个月,PDQ-39评分、UPDRS-Ⅲ评分、LEDD均明显降低(P<0.05)。恶化组尾状核指数、第三脑室宽度较改善组明显增大(P<0.05),而Evans指数无明显变化(P>0.05)。多因素logistic回归分析显示尾状核指数≥0.16(OR=1.76;95% CI 1.09~3.18;P=0.017)是PD术后UPDRS-Ⅲ评分恶化的独立影响因素。结论 双侧GPi-DBs明显改善PD症状,尾状核指数可用于评估PD病人双侧GPi-DBS后运动功能。
Abstract:
Objective To investigate the effect of bicaudate index on the outcomes of deep brain stimulation (DBS) for patients with Parkinson's disease (PD). Methods The clinical data of 36 patients with PD who underwent bilateral globus pallidus interna (GPi) DBS between August 2018 and December 2020 were analyzed retrospectively. The bicaudate index, the Evans index and the width of the third ventricle were measured using MRI before operation. The efficacy was evaluated using the 39-item Parkinson's Disease Questionnaire (PDQ-39) score, Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS-Ⅲ) score and levodopa equivalent daily dose (LEDD) before and 6 months after surgery. According to the UPDRS-Ⅲ score at 6 months after operation, the patients were divided into improvement group (n=26) and deterioration group (n=10). Results At 6 months after operation, PDQ-39 score and UPDRS-Ⅲ score were significantly improved (P<0.05), and LEDD was significantly decreased (P<0.05). The bicaudate index and the width of the third ventricle in the deterioration group were significantly higher than those in the improved group (P<0.05), while the Evans index did not significantly change (P>0.05). Multivariate logistic regression analysis showed that bicaudate index ≥0.16 was an independent risk factor of UPDRS-Ⅲ score deterioration after DBS (OR=1.76; 95% CI 1.09~3.18; P=0.017). Conclusions Bilateral GPi-DBS significantly improves PD symptoms. Bicaudate nucleus index can be used to evaluate motor function after bilateral GPI-DBS in PD patients.

参考文献/References:

[1] Zhang ZX, Roman GC, Hong Z, et al. Parkinson's disease in China: prevalence in Beijing, Xian, and Shanghai [J]. Lancet, 2005, 365(9459): 595-597.
[2] 冼文彪,陈 玲. 帕金森病脑深部电刺激治疗[J]. 中国实用内科杂志,2019,39(9):778-782.
[3] Ramirez-Zamora A, Ostrem JL. Globus pallidus interna or subthalamic nucleus deep brain stimulation for Parkinson disease: a review [J]. JAMA Neurol, 2018, 75(3): 367-372.
[4] Muthuraman M, Deuschl G, Koirala N, et al. Effects of DBS in parkinsonian patients depend on the structural integrity of frontal cortex [J]. Sci Rep, 2017, 7(6): 43571
[5] Djordjevic G, Stojanov A, Bozovic I, et al. Six-month prospective study of quality of life in Guillain-Barre syndrome [J]. Acta Neurol Scand, 2020, 141(3): 236-241.
[6] Martinez-Ramirez D, Foote KD, Okun MS. Atrophy is a real phenomenon that can result in changes in deep brain stimulation outcome [J]. J Epilepsy Res, 2016, 6(1): 42-43.
[7] 中华医学会神经病学分会帕金森病及运动障碍学组,中国医师协会神经内科医师分会帕金森病及运动障碍专业委员会. 中国帕金森病的诊断标准(2016版)[J]. 中华神经科杂志,2016,49(4):268-271.
[8] Aylward EH, Schwartz J, Machlin S, et al. Bicaudate ratio as a measure of caudate volume on MR images [J]. AJNR Am J Neuroradiol, 1991, 12(6): 1217-1222.
[9] Barr AN, Heinze WJ, Dobben GD, et al. Bicaudate index in computerized tomography of Huntington disease and cere-bral atrophy [J]. Neurology, 1978, 28(11): 1196-1200.
[10] Fukaya C, Watanabe M, Kobayashi K, et al. Predictive factors for long-term outcome of subthalamic nucleus deep brain stimulation for Parkinson's disease [J]. Neurol Med Chir (Tokyo), 2017, 57(4): 166-171.
[11] Welter ML, Houeto JL, Tezenas du Montcel S, et al. Clinical predictive factors of subthalamic stimulation in Parkinson's disease [J]. Brain, 2002, 125(Pt3): 575-583.
[12] Acharya HJ, Bouchard TP, Emery DJ, et al. Axial signs and magnetic resonance imaging correlates in Parkinson's disease [J]. Can J Neurol Sci, 2007, 34(1): 56-61.
[13] Price CC, Favilla C, Tanner JJ, et al. Lateral ventricle volume is poor predictor of post unilateral DBS motor change for Parkinson's disease [J]. Parkinsonism Relat
Disord, 2011, 17(5): 343-347.
[14] Younce JR, Campbell MC, Perlmutter JS, et al. Thalamic and ventricular volumes predict motor response to deep brain stimulation for Parkinson's disease [J]. Parkinsonism Relat Disord, 2019, 61: 64-69.

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备注/Memo

备注/Memo:
(2022-07-08收稿,2022-08-15修回)
通讯作者:杨威,E-mail:yest2001@qq.com
更新日期/Last Update: 2022-10-31