期刊
PARKINSONISM & RELATED DISORDERS
卷 75, 期 -, 页码 7-13出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2020.05.004
关键词
Parkinson's disease; Globus pallidus internus; Pallidum; Deep brain stimulation; Quality of life
资金
- NIH
- Donnellan/Einstein/Merz Chair
- Medtronic
- Functional Neuromodulation
- Boston Scientific
- Neurospace
- NPF
- Michael J. Fox Foundation
- Parkinson Alliance
- Smallwood Foundation
- Bachmann-Strauss Foundation
- Tourette Syndrome Association
- UF Foundation
- PeerView
- Prime
- QuantiaMD
- WebMD
- Medicus
- MedNet
- Henry Stewart
- Vanderbilt University
- Abbvie
- Allergan
- ANS/St. Jude
- St Jude
- [R01 NR014852]
- [R01NS096008]
Objective: We aimed to explore the differences in motor symptoms and quality of life (QOL) outcomes following bilateral globus pallidus internus deep brain stimulation (GPi DBS), across well-defined motor subtypes of Parkinson's disease (PD), to improve clinical decision making. Methods: This single-center retrospective study investigated bilateral GPi DBS outcomes in 65 PD patients. Outcome measures included the Unified Parkinson's Disease Rating Scale (UPDRS) and Parkinson's Disease Questionnaire (PDQ-39) before and one year after surgery. Outcomes were compared between the tremordominant (TD) and postural instability and gait difficulty (PIGD) subtypes and between the TD and akinetic-rigid (AR) subtypes. Results: For the entire cohort, motor function (UPDRS III) in the Off-medication state, motor complications (UPDRS IV), activities of daily living (ADL, UPDRS II), and the ADL and discomfort domains of PDQ-39 significantly improved one year following GPi implantation compared to baseline (effect size = 1.32, 1.15, 0.25, 0.45, and 0.34, respectively). GPi DBS improved the Off-medication UPDRS III scores regardless of the motor subtypes. However, compared to the PIGD and AR patients, the TD patients showed greater improvement in overall UPDRS III postoperatively primarily due to greater tremor improvement in the Off-medication state. The outcomes in akinesia, rigidity, axial symptoms and QOL were similar among all subtypes. Conclusion: Bilateral GPi DBS was effective for advanced PD patients regardless of motor subtypes. Greater tremor improvement in the TD patients accounted for greater Off-medication motor improvement. Longer-term GPi DBS outcomes across different motor subtypes and brain targets should be further studied.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据