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Deep Brain Stimulation Target Selection for Parkinson's Disease

机译:对帕金森病的深脑刺激目标选择

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摘要

During the "DBS Canada Day" symposium held in Toronto July 4-5, 2014, the scientific committee invited experts to discuss three main questions on target selection for deep brain stimulation (DBS) of patients with Parkinson's disease (PD). First, is the subthalamic nucleus (STN) or the globus pallidus internus (GPi) the ideal target? In summary, both targets are equally effective in improving the motor symptoms of PD. STN allows a greater medications reduction, while GPi exerts a direct antidyskinetic effect. Second, are there further potential targets? Ventral intermediate nucleus DBS has significant long-term benefit for tremor control but insufficiently addresses other motor features of PD. DBS in the posterior subthalamic area also reduces tremor. The pedunculopontine nucleus remains an investigational target. Third, should DBS for PD be performed unilaterally, bilaterally or staged? Unilateral STN DBS can be proposed to asymmetric patients. There is no evidence that a staged bilateral approach reduces the incidence of DBS-related adverse events.
机译:在“DBS加拿大日”研讨会上在2014年7月4日至5日在2014年7月4日举行的研讨会期间,科学委员会邀请专家讨论了帕金森病(PD)的深脑刺激(DBS)的目标选择的三个主要问题。首先,是亚饱和核(STN)或Globus pallidus Internus(GPI)是理想的目标吗?总之,两种靶标在改善PD的电机症状方面同样有效。 STN允许减少更大的药物,而GPI施加直接的解毒效果。第二,是否有进一步的潜在目标?腹侧中间核DBS对震颤控制具有显着的长期优势,但不充分地解决PD的其他电机特征。后亚血管区域中的DB也减少了震颤。 ped鱼鲨弥α核核心仍然是调查目标。第三,是否应该单方面进行PD的DBS,双侧或上演?可以提出单侧STN DBS到不对称患者。没有证据表明分阶段的双侧方法降低了与DBS相关不良事件的发生率。

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