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首页> 外文期刊>Neurosurgery >Subthalamic nucleus stimulation for gait disturbance in Parkinson's disease.
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Subthalamic nucleus stimulation for gait disturbance in Parkinson's disease.

机译：丘脑下核刺激治疗帕金森氏病的步态障碍。

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OBJECTIVE: A preliminary study of subthalamic nucleus (STN) stimulation was performed to determine its applicability for the treatment of gait and postural disturbances in Parkinson's disease. METHODS: Five Parkinson's disease patients with freezing gait and postural instability were selected for this study. Their ages ranged from 60 to 73 years (mean+/-standard deviation, 65.6+/-4.8 years). Semi-microelectrode recording was used to identify the STN and to place a chronic electrical stimulation electrode within the right STN in all patients. The Unified Parkinson's Disease Rating Scale and the modified Hoehn and Yahr Staging Scale were used to assess patients in on- and off-drug conditions before surgery and 3 months after surgery. RESULTS: The scores on the Hoehn and Yahr Staging Scale and the total Unified Parkinson's Disease Rating Scale for akinesia (P < 0.05), gait (P < 0.05), and gait and posture (P < 0.01) in off-drug on-stimulation conditions significantly improved over the preoperative and postoperative off-drug off-stimulation conditions (analysis of variance [ANOVA], P < 0.01). Improvement over the preoperative scores was 24% on the Hoehn and Yahr Staging Scale, 43.6% on the total Unified Parkinson's Disease Rating Scale, 33.4% for akinesia, 36.6% for gait, and 38.7% for gait and posture. However, stimulation in the on-drug phase did not show a significant difference compared with pre- and postoperative conditions (ANOVA, P > 0.05). Comparisons between preoperative on-drug and postoperative off-drug on-stimulation conditions revealed that there were no significant differences in the scores, except for gait (ANOVA, P < 0.05). The scores on subscales for falling, freezing, walking, and gait in off-drug on-stimulation conditions were significantly improved over the scores for preoperative and postoperative off-stimulation (ANOVA, P < 0.05), but the score for postural stability remained unchanged. CONCLUSION: Our findings showed that STN stimulation effectively alleviates freezing gait and improves walking to its status during the preoperative on-drug phase and can be applied for treatment of Parkinson's disease patients with these symptoms.
机译：目的：对丘脑底核（STN）刺激进行初步研究，以确定其在治疗帕金森氏病步态和姿势障碍中的适用性。方法：选择5例步态冻结且姿势不稳的帕金森氏病患者。他们的年龄从60到73岁不等（平均+/-标准偏差，65.6 +/- 4.8岁）。使用半微电极记录来识别所有患者的STN并将慢性电刺激电极放置在正确的STN内。统一的帕金森氏病评分量表和改良的Hoehn和Yahr分期量表用于评估术前和术后3个月处于药物内和药物外状况的患者。结果：Hoehn和Yahr分期量表以及帕金森病统一运动不及格量表（P <0.05），步态（P <0.05）和步态和姿势（P <0.01）的得分与术前和术后的非药物刺激条件相比，病情明显改善（方差分析[ANOVA]，P <0.01）。在Hoehn和Yahr分期量表上，术前评分的改善为24％，在整体帕金森综合疾病评估量表上为43.6％，运动障碍的为33.4％，步态的为36.6％，步态和姿势的为38.7％。然而，与术前和术后情况相比，在药物阶段的刺激没有显示出显着差异（ANOVA，P> 0.05）。术前用药和术后用药后刺激条件的比较表明，除步态外，得分均无显着性差异（ANOVA，P <0.05）。药物刺激下条件下跌倒，冰冻，行走和步态的分量表得分明显高于术前和术后刺激后得分（ANOVA，P <0.05），但姿势稳定性得分保持不变。结论：我们的研究结果表明，STN刺激可有效缓解冰冻步态，并改善术前药物治疗阶段的步态，可用于治疗具有这些症状的帕金森氏病患者。

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