deep brain stimulation;
Parkinson disease;
subthalamic nucleus;
D O I:
10.3171/jns.2003.99.1.0071
中图分类号:
R74 [神经病学与精神病学];
学科分类号:
摘要:
Object. Bilateral subthalamic nucleus (STN) stimulation is increasingly used in patients with advanced Parkinson disease (PD). This study was performed to evaluate the long-term efficacy and safety of bilateral STN stimulation in cases of PD. Methods. The authors performed a prospective, open-label study in patients with PD who underwent bilateral STN stimulation. The authors compared motor scores and activities of daily living (ADL) scores based on the Unified PD Rating Scale (UPDRS) obtained before surgery while patients were in the medication-off state with scores obtained at follow-up evaluations of these patients while in the medication-off/stimulator-on state. Data contained in patient diaries were also compared. Thirty-three patients with PD were evaluated 12 months postoperatively and 19 were evaluated at a mean follow-up time of 28 months. A comparison between UPDRS scores obtained in patients in the medication-off/stimulator-on state and those obtained when patients were in the baseline medication-off state showed a 27% improvement in ADL scores and a 28% improvement in motor scores after surgery. There was a 57% reduction in the use of levodopa-equivalent medication doses. The percentage of the waking day that patients were in the medication-on state increased from 38 to 72%. Surgical complications included seizures (three patients), confusion (five patients), hemiballismus (one patient), and visual disturbance (one patient). Stimulation-related adverse effects were mild. Device-related events included nine lead replacements, seven lead revisions, six extension replacements, and 12 implantable pulse generator (IPG) replacements; one IPG was cleaned and one IPG was placed in a pocket because of the presence of a shunt. Conclusions. Bilateral STN simulation is associated with a significant improvement in the motor features of PD. Device-related events were common in the first 20 patients who underwent surgery, often requiring repeated surgeries.
机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Daniel Weiss
Kathrin Brockmann
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Kathrin Brockmann
Karin Srulijes
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Karin Srulijes
Christoph Meisner
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Christoph Meisner
Rosa Klotz
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Rosa Klotz
Sophia Reinbold
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Sophia Reinbold
Ann-Kathrin Hauser
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Ann-Kathrin Hauser
Claudia Schulte
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Claudia Schulte
Daniela Berg
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Daniela Berg
Thomas Gasser
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Thomas Gasser
Christian Plewnia
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Christian Plewnia
Alireza Gharabaghi
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Alireza Gharabaghi
Sorin Breit
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Sorin Breit
Tobias Wächter
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
Tobias Wächter
Rejko Krüger
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机构:German Centre of Neurodegenerative Diseases,Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases
机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Wang, Xuelian
Chang, Chongwang
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机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Chang, Chongwang
Geng, Ning
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h-index: 0
机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Geng, Ning
Li, Nan
论文数: 0引用数: 0
h-index: 0
机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Li, Nan
Wang, Julei
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h-index: 0
机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Wang, Julei
Ma, Jiuhong
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机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Ma, Jiuhong
Xue, Weining
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h-index: 0
机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Xue, Weining
Zhao, Wei
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h-index: 0
机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Zhao, Wei
Wu, Heming
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h-index: 0
机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Wu, Heming
Wang, Peng
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h-index: 0
机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
Wang, Peng
Gao, Guodong
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h-index: 0
机构:
Fourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R ChinaFourth Mil Med Univ, Dept Neurosurg, Tangdu Hosp, Xian 710038, Shaanxi Prov, Peoples R China
机构:
Buddhist Tzu Chi Gen Hosp, Dept Neurol, Hualien, TaiwanBuddhist Tzu Chi Gen Hosp, Dept Neurol, Hualien, Taiwan
Liu, H. H.
Lin, S. H.
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机构:
Buddhist Tzu Chi Gen Hosp, Dept Neurol, Hualien, Taiwan
Buddhist Tzu Chi Univ, Dept Neurol, Buddhist Tzu Chi Gen Hosp, Hualien, Taiwan
Natl Taiwan Univ, Inst Biomed Engn, Coll Med, Taipei, TaiwanBuddhist Tzu Chi Gen Hosp, Dept Neurol, Hualien, Taiwan
Lin, S. H.
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机构:
Chen, S. Y.
Tsai, S. T.
论文数: 0引用数: 0
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机构:
Buddhist Tzu Chi Univ, Dept Neurosurg, Buddhist Tzu Chi Gen Hosp, Hualien, TaiwanBuddhist Tzu Chi Gen Hosp, Dept Neurol, Hualien, Taiwan