[1]邵钰阳,杨鑫,聂盼,等.交叉电脉冲在帕金森病DBS后程控中的应用[J].中国临床神经外科杂志,2022,27(11):889-891952.[doi:10.13798/j.issn.1009-153X.2022.11.003]
　SHAO Yu-yang,YANG Xin,NIE Pan,et al.Application of interleaving stimulation in patients with Parkinson's disease after deep brain stimulation[J].,2022,27(11):889-891952.[doi:10.13798/j.issn.1009-153X.2022.11.003]
点击复制

交叉电脉冲在帕金森病DBS后程控中的应用()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年11期
页码:
889-891952
栏目:
论著
出版日期:
2022-11-30

文章信息/Info

Title:
Application of interleaving stimulation in patients with Parkinson's disease after deep brain stimulation
文章编号:
1009-153X（2022）11-0889-03
作者:
邵钰阳; 杨鑫; 聂盼; 张修民; 付锴; 熊文平; 柳雯; 张继波; 陈劲草; 张捷
430071 武汉，武汉大学中南医院神经外科/功能神经外科中心（邵钰阳、杨鑫、聂盼、张修民、付锴、熊文平、柳雯、张继波、陈劲草、张捷）
Author(s):
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
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
Keywords:
Parkinson disease;  Subthalamic nucleus;  Deep brain stimulation;  Interleaving stimulation;  Postoperative programming
分类号:
R742.5;R651.1+1
DOI:
10.13798/j.issn.1009-153X.2022.11.003
文献标志码:
A
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（UPDRS Ⅱ）评分、运动量表（UPDRS Ⅲ）评分、异动症量表（UPDRS Ⅳ-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、UPDRS Ⅳ-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。
Abstract:
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 (UPDRS Ⅱ), Exercise Scale (UPDRS Ⅲ) and UPDRS Ⅳ-A and levodopa equivalent daily dose (LEDD) was used to evaluate the drug use 6~12 months after ILS. Results The UPDRS Ⅱ score, the UPDRS Ⅲ score and the UPDRS Ⅳ-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.

参考文献/References:

[1] de Rijk MC, Rocca WA, Anderson DW, et al. A population perspective on diagnostic criteria for Parkinson's disease [J]. Neurology, 1997, 48(5): 1277-1281.
[2] Okun MS. Deep-brain stimulation for Parkinson's disease [J]. N Engl J Med, 2012, 367(16): 1529-1538.
[3] Koeglsperger T, Palleis C, Hell F, et al. Deep brain stimulation programming for movement disorders: current concepts and evidence-based strategies [J]. Front Neurol, 2019, 10: 410.
[4] 杨　鑫，邵钰阳，聂　盼，等. 脑深部电刺激术治疗毁损术后帕金森病的疗效 [J]. 中国临床神经外科杂志，2021，26（12）：904-906，911.
[5] Miocinovic S, Khemani P, Whiddon R, et al. Outcomes, management, and potential mechanisms of interleaving deep brain stimulation settings [J]. Parkinsonism Relat Disord, 2014, 20(12): 1434-1437.
[6] Franca C, Barbosa ER, Iglesio R, et al. Interleaving stimulation in Parkinson disease: interesting to whom [J]. World Neurosurg, 2019, 130: e786-e793.
[7] Aquino CC, Duffley G, Hedges DM, et al. Interleaved deep brain stimulation for dyskinesia management in Parkinson's disease [J]. Mov Disord, 2019, 34(11): 1722-1727.
[8] Kern DS, Picillo M, Thompson JA, et al. Interleaving stimulation in Parkinson's disease, tremor, and dystonia [J]. Stereotact Funct Neurosurg, 2018, 6(6): 379-391.
[9] Blomstedt P, Stenmark Persson R, Hariz GM, et al. Deep brain stimulation in the caudal zona incerta versus best medical treatment in patients with Parkinson's disease: a randomrised blinded evaluation [J]. J Neurol Neurosurg Psychiatry, 2018, 89: 710-716.
[10] 陈礼道，张修民，聂　盼，等. 帕金森病丘脑底核脑深部电刺激术后程控分析[J]. 中华神经外科杂志，2019，35(12)：210-1215.
[11] Anderson TR, Hu B, Iremonger K, et al. Selective attenuation of afferent synaptic transmission as a mechanism of thalamic deep brain stimulation-induced tremor arrest [J]. J Neurosci, 2006, 26(3): 841-850.
[12] Wojtecki L, Vesper J, Schnitzler A. Interleaving programming of subthalamic deep brain stimulation to reduce side effects with good motor outcome in a patient with Parkinson's disease [J]. Parkinsonism Relat Disord, 2011, 17(4): 293-294.
[13] Zhang S, Zhou P, Jiang S, et al. Interleaving subthalamic nucleus deep brain stimulation to avoid side effects while achieving satisfactory motor benefits in Parkinson disease: a report of 12 cases [J]. Medicine (Baltimore), 2016, 95(49): e5575.

相似文献/References:

[1]欧阳佳　武广永 综述　刘如恩 审校.帕金森病基因治疗研究进展[J].中国临床神经外科杂志,2015,(03):187.[doi:10.13798/j.issn.1009-153X.2015.03.022]
[2]杨张凯　王学廉　汪　鑫　李　楠　葛顺楠　陈　磊　曲　亮　李　洋.脑深部电刺激治疗肌张力障碍的疗效分析[J].中国临床神经外科杂志,2015,(01):21.[doi:10.13798/j.issn.1009-153X.2015.01.007]
　YANG Zhang-kai,WANG Xue-lian,WANG Xin,et al.Curative effect of deep brain stimulation of different targets on myodystonia[J].,2015,(11):21.[doi:10.13798/j.issn.1009-153X.2015.01.007]
[3]杨振宇　张　捷　付　锴　张继波　赵时雨　王　伟.丘脑底核电刺激术治疗肌张力障碍3例并文献复习[J].中国临床神经外科杂志,2015,(01):41.[doi:10.13798/j.issn.1009-153X.2015.01.013]
[4]管得宁,张　扬,徐　运.帕金森病的发病机制及治疗研究进展[J].中国临床神经外科杂志,2016,(11):732.[doi:10.13798/j.issn.1009-153X.2016.11.031]
[5]陈礼道　柳　雯　张　捷　付　锴　张继波　刘学猛　彭启珍　丁　伟.脂质头皮标志物在脑深部电刺激术针道设计中的应用[J].中国临床神经外科杂志,2017,(09):619.[doi:10.13798/j.issn.1009-153X.2017.09.004]
　CHEN Li-dao,LIU Wen,ZHANG Jie,et al.Application of lipid scalp markers to the design of electrode track for deep brain stimulation in patients with movement disorders[J].,2017,(11):619.[doi:10.13798/j.issn.1009-153X.2017.09.004]
[6]陈宇昆 综述　王学廉 审校.脑深部电刺激术治疗帕金森病新进展[J].中国临床神经外科杂志,2018,(01):56.[doi:10.13798/j.issn.1009-153X.2018.01.024]
[7]陈礼道 综述　张　捷 审校.帕金森病脑深部电刺激术后程控策略[J].中国临床神经外科杂志,2018,(07):506.[doi:10.13798/j.issn.1009-153X.2018.07.021]
[8]阿不都拉·艾沙,魏汝锐,王霞,等.经颅超声在STN-DBS电极植入术靶点定位中的应用[J].中国临床神经外科杂志,2022,27(08):650.[doi:10.13798/j.issn.1009-153X.2022.08.008]
　ABUDULA Aisha,WEI Rui-rui,WANG Xia,et al.Application of transcranial sonography to guide localization of electrode implantation during STN-DBS for patients with movement disorder[J].,2022,27(11):650.[doi:10.13798/j.issn.1009-153X.2022.08.008]
[9]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.[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(11):742.[doi:10.13798/j.issn.1009-153X.2022.09.007]
[10]张　威　李　楠　张海红　马　磊　高金鉴 王学廉　高国栋.丘脑底核与苍白球内侧部电刺激术治疗帕金森病疗效的Meta分析[J].中国临床神经外科杂志,2015,(12):718.[doi:10.13798/j.issn.1009-153X.2015.12.005]
　ZHANG Wei,LI Nan,ZHANG Hai-hong,et al.Meta-analysis of curative effects of electric stimulation of the globus pallidus and subthalamic nucleus on Parkinson disease[J].,2015,(11):718.[doi:10.13798/j.issn.1009-153X.2015.12.005]
[11]姜　磊　邵　华　王西宪　石　鑫　冯兆海　郝玉军.丘脑底核电刺激术治疗帕金森病的疗效观察[J].中国临床神经外科杂志,2019,(01):13.[doi:10.13798/j.issn.1009-153X.2019.01.003]
　JIANG Lei,SHAO Hua,WANG Xi-xian,et al.Curative effect of deep brain stimulation of subthalamic nucleus on Parkinson’s disease[J].,2019,(11):13.[doi:10.13798/j.issn.1009-153X.2019.01.003]
[12]张建英　马立山.DBS对帕金森病病人精神症状及认知功能的影响[J].中国临床神经外科杂志,2020,(10):703.[doi:10.13798/j.issn.1009-153X.2020.10.014]
[13]郭　松　任志伟　胡永生等.单纯影像定位与微电极辅助定位在帕金森病手术中的应用[J].中国临床神经外科杂志,2021,26(03):149.[doi:10.13798/j.issn.1009-153X.2021.03.002]
　GUO Song,REN Zhi-wei,HU Yong-sheng,et al.Simple imaging-guided versus microelectrode recording-guided deep brain stimulaton for patients with Parkinson’s disease[J].,2021,26(11):149.[doi:10.13798/j.issn.1009-153X.2021.03.002]
[14]蒋　伟　郐国虎　刘魏华等.双侧丘脑底核脑深部电刺激术治疗帕金森病的疗效分析[J].中国临床神经外科杂志,2021,26(10):755.[doi:10.13798/j.issn.1009-153X.2021.10.004]
　JIANG Wei,KUAI Guo-hu,LIU Wei-hua,et al.Clinical efficacy of bilateral subthalamic nucleus deep brain stimulation for patients with Parkinson’s disease[J].,2021,26(11):755.[doi:10.13798/j.issn.1009-153X.2021.10.004]
[15]杨　鑫　邵钰阳　聂　盼等.脑深部电刺激术治疗毁损术后帕金森病的疗效[J].中国临床神经外科杂志,2021,26(12):904.[doi:10.13798/j.issn.1009-153X.2021.12.003]
　YANG Xin,SHAO Yu-yang,NIE Pan,et al.Efficacy of deep brain stimulation for patients with Parkinson’s disease after lesion surgery[J].,2021,26(11):904.[doi:10.13798/j.issn.1009-153X.2021.12.003]

备注/Memo

备注/Memo:
（2022-08-15收稿，2022-09-28修回）
基金项目：科技部国家重点研发计划（2016YFC0105900）
通讯作者：张　捷，E-mail：zhangjie8790@163.com
更新日期/Last Update: 2022-12-31