丘腦底核電刺激術(shù)治療帕金森病前瞻性研究及丘腦底核有效刺激體積與療效的相關性研究

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【中圖分類號】R742.5；R651 【文獻標志碼】A 【文章編號】1672-7770（2025）03-0248-06

Abstract： Objective To evaluate the efficacy and safety of subthalamic nucleus（STN） deep brain stimulation（DBS）under general anesthesia in the treatment of Parkinson’s disease（PD）.The correlation between STN and to analyze subregion effective volume of tissue activated（VTA）and clinical symptoms.MethodsA total of 40 patients with PD who underwent bilateral STN DBS surgery in the Department of Neurosurgery，Nanchong from January 2O24 to June 2024 were collected. The clinical efficacy of patients in terms of movement（UPDRS-II），anxiety （HAMA），depression（HAMD），cognition（MoCA），quality of life（PDQ-39），etc were analyzed before surgery and three months after surgery. The Lead DBS software was used to reconstruct the electrodes，contacts and implanted target nuclei and subregions，and STN and subregion VTA could be accurately calculated，and the correlation between STN and subregion VTA and the preoperative and postoperative changes in clinical symptoms can be analyzed. ResultsAt the follow-up 3 months after surgery，UPDRS-II，HAMA and HAMD were significantly decreased（ P=0.035 ）， MoCA was not significantly decreased（ P=0.078 ），and PDQ-39 was significantly decreased（ P< 0.001）. LEDD decreased significantly（ P<0.001 ）.Correlation analysis showed that the change of

UPDRS-II score was significantly positively correlated with total STN-VTA （ r=0.607 ， P<0.001 ） and STN motor- VTA（ r=0.587 ， P<0.001 ）. There was a significant positive correlation between life quality score and STN motor-VTA（ r=0.612 ， P=0.025 ）. ConclusionsSTN DBS can significantly improve the motor symptoms，anxiety and depression of PD patients， improve the quality of life， reduce the amount of medication，and have litle impact on cognitive function. Lead DBS can be used as one of the auxiliary means of postoperative visual precision program control for STN DBS in PD.

Key words： Parkinson's disease； deep brain stimulation； subthalamic nucleus； generalanesthesia；volume of tissue activated

帕金森?。≒arkinson'sdisease，PD）是常見的神經(jīng)系統(tǒng)退行性疾病，其癥狀包括運動癥狀和非運動癥狀。（剩余10759字）