VoltageadjustmentimprovesrigidityandtremorinParkinsonsdiseasepatientsreceivingdeepbrainstimulation

摘要： DeepbrainstimulationofthesubthalamicnucleusisrecognizedasthemosteffectivetreatmentformoderateandadvancedParkinsonsdisease.Programmingofthestimulationparametersisimportantformaintainingtheefficacyofdeepbrainstimulation.Voltageisconsideredtobethemosteffectiveprogrammingparameter.ThepresentstudyisaretrospectiveanalysisofsixpatientswithParkinsonsdisease(fourmenandtwowomen,aged37–65years),whounderwentbilateraldeepbrainstimulationofthesubthalamicnucleusattheFirstAffiliatedHospitalofSunYat-senUniversity,China,andwhosubsequentlyadjustedonlythestimulationvoltage.WeevaluatedmotorsymptomseverityusingtheUnifiedParkinsonsDiseaseRatingScalePartⅢ,symptomprogressionusingtheHoehnandYahrscale,andthelevodopaequivalentdailydose,beforesurgeryand1and2yearsaftersurgery.The2-yearfollow-upresultsshowthatrigidityandtremorimproved,andclinicalsymptomswerereduced,whilepulsewidthwasmaintainedat60μsandfrequencyat130Hz.Voltageadjustmentaloneisparticularlysuitableforpatientswhocannottoleratemultiparameterprogramadjustment.Levodopaequivalentdailydosewasmarkedlyreduced1and2yearsaftersurgerycomparedwithbaseline.Ourresultsconfirmthatrigidity,tremorandbradykinesiacanbebestalleviatedbyvoltageadjustment. ... （共6頁）