GPi/GPe borderland- a potential sweet spot for deep brain stimulation for chorea in Huntington's disease?

Q2 Medicine
Julia Steinhardt, Simone Zittel, Vera Tadic, Volker Tronnier, Christian Moll, Tobias Bäumer, Alexander Münchau, Dirk Rasche, Norbert Brüggemann
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Abstract

Background: Pallidal deep brain stimulation (GPi-DBS) has been considered as an effective treatment option for medication-refractory Huntington's disease (HD).

Objectives: To identify stimulation-dependent effects on motor symptoms and to determine if these alterations are associated with the local impact of DBS on different pallidal parcellations.

Methods: We prospectively evaluated the effects of bilateral GPi-DBS within one year in 5 HD patients. We evaluated the effects of GPi-DBS on choreatic symptoms and UHDRS. Electrode placement in the pallidum was localized, and the local impact of DBS was estimated.

Results: The chorea subscore (p < 0.001) and UHDRS total motor score was significantly reduced postoperatively (p = 0.019). Pallidal DBS did not improve other motor symptoms. Activation of the lateral GPi/GPe was associated with improvement in choreatic symptoms (p = 0.048; r = 0.90).

Conclusions: Our findings indicate that stimulation of the lateral GPi has a stable effect on choreatic symptoms. The modulation of the electrical field is relevant for motor outcome.

GPi/GPe 边界--深部脑刺激治疗亨廷顿舞蹈症的潜在甜蜜点?
背景:苍白球深部脑刺激(GPi-DBS)被认为是治疗药物难治性亨廷顿氏病(HD)的有效方法:目的:确定刺激对运动症状的影响,并确定这些改变是否与DBS对不同丘脑旁的局部影响有关:我们对 5 名 HD 患者一年内双侧 GPi-DBS 的效果进行了前瞻性评估。我们评估了 GPi-DBS 对胆囊症状和 UHDRS 的影响。对苍白球的电极放置进行了定位,并估计了 DBS 对局部的影响:结果:胆汁淤积子分数(p 结论:GPi-DBS 对胆汁淤积症状和 UHDRS 有显著影响:我们的研究结果表明,刺激外侧 GPi 对胆囊症状有稳定的影响。电场的调节与运动结果有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.40
自引率
0.00%
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审稿时长
14 weeks
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