丘脑底核电刺激术治疗帕金森病前瞻性研究及丘脑底核有效刺激体积与疗效的相关性研究

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【中图分类号】R742.5；R651 【文献标志码】A 【文章编号】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

帕金森病（Parkinson'sdisease，PD）是常见的神经系统退行性疾病，其症状包括运动症状和非运动症状。（剩余10759字）