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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Subthalamic Nucleus Stimulation in Pediatric Isolated Dystonia: A 10-Year Follow-up
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Subthalamic Nucleus Stimulation in Pediatric Isolated Dystonia: A 10-Year Follow-up

机译：小儿分离肌瘤的亚饱和核刺激：10年的随访

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Objective: To evaluate the short-term and long-term clinical effectiveness and safety of subthalamic nucleus deep brain stimulation (STN-DBS) for medically intractable pediatric isolated dystonia. Methods: Using a longitudinal retrospective design, we assessed the clinical outcomes of nine patients who underwent STN-DBS for treatment-refractory pediatric isolated dystonia one decade ago (mean age at surgery: 15.9 +/- 4.5 years). The primary clinical outcome used was assessed by retrospective video analyses of patients' dystonia symptoms using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). Clinical assessments were performed at baseline, 1-year follow-up (1-yr FU), and 10-year follow-up (10-yr FU). Adverse side effects, including surgery-related, device-related, and stimulation-related effects, were also documented. Results: After STN-DBS surgery, the mean improvement in the BFMDRS motor score was 77.1 +/- 26.6% at 1-yr FU and 90.4 +/- 10.4% at 10-yr FU. Similarly, the mean BFMDRS disability score was improved by 69.5 +/- 13.6% at 1-yr FU and by 86.5 +/- 13.9% at 10-yr FU. The clinical improvements gained at 10-yr FU were significantly larger than those observed at 1-yr FU. Negative correlations were found between the duration of disease to age at surgery ratio (DD/AS) and the improvements in the BFMDRS motor score and total score at 1-yr FU and 10-yr FU. Conclusion: To our knowledge, this study provides the first clinical evidence for the short- and long-term effectiveness and safety of STN-DBS for pediatric isolated dystonia. Additionally, putative evidence is provided that earlier STN-DBS intervention in patients with refractory pediatric isolated dystonia may improve short- and long-term clinical outcomes.
机译：目的：评价微核核心刺激（STN-DBS）的短期和长期临床疗效和安全性治疗难治性儿科分离肌瘤。方法：采用纵向回顾性设计，我们评估了十年前的治疗难治性儿科分离肌肌肌腹腹部患者的九九患者的临床结果（手术时年龄：15.9 +/- 4.5岁）。使用Burke-Fahn-Marsden Dystonia评级规模（BFMDRS）的患者缺陷症状的回顾性视频分析评估了使用的主要临床结果。临床评估在基线进行，1年后续（1-YR FU）和10年后（10-YR FU）进行。还记录了不良副作用，包括外科有关的，与手术相关的和刺激相关的效果。结果：在STN-DBS手术后，BFMDRS的平均改善在10岁的1 yr富和90.4 +/-10.4％下为77.1 +/- 26.6％。类似地，平均BFMDRS残疾分数在1-YR FU和10岁的富力下提高了69.5 +/- 13.6％。在10 yr fu的临床改善显着大于1 - YR福观察到的临床。在手术比（DD / AS）以年龄（DD / AS）的疾病持续时间（DD / AS）之间发现了负相关性，并在1-YR FU和10-YR FU的BFMDRS电机得分和总分中的改进。结论：据我们所知，本研究为第一个临床证据提供了第一个临床证据，即STN-DBS用于儿科分离障碍的短期和长期有效性和安全性。此外，提供了规定的证据，即难治性儿科分离障碍患者的早期STN-DBS干预可能改善短期和长期临床结果。

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