血管内深部脑刺激丘脑前核治疗难治性癫痫的可行性。

IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY
Operative Neurosurgery Pub Date : 2025-01-01 Epub Date: 2024-06-13 DOI:10.1227/ons.0000000000001226
Varun Kashyap, Mark Ashby, Scott Stanslaski, Kevin Nguyen, Kristin Hageman, Yao-Chuan Chang, Alexander A Khalessi
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引用次数: 0

摘要

背景和目的:脑深部刺激(DBS)已发展成为治疗多种疾病的有效疗法,包括耐药帕金森病和药物难治性本质性震颤,以及节段性肌张力障碍、全身性肌张力障碍、颈性肌张力障碍和强迫症(OCD)。肌张力障碍和强迫症获得了人道主义设备豁免。此外,DBS 还被批准用于治疗丘脑前核癫痫。虽然 DBS 总体上被认为是治疗帕金森病和癫痫的有效方法,但决定 DBS 治疗成功与否的具体因素有很多,包括患者的谨慎选择、DBS 设备的有效术后编程以及电极的准确放置。此外,手术的创伤性也限制了患者的采用率。方法:在此,我们首次报告了在一式三份的雌性动物模型中,以丘脑前核为实质靶点,直接比较血管内和实质 DBS 治疗难治性癫痫的效果:结果:一式三份的绵羊研究显示,血管内 DBS 与实质 DBS 的传感分辨率和刺激性能相当:这项可行性研究的结果为微创 DBS 治疗开辟了一个新领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Feasibility of Endovascular Deep Brain Stimulation of Anterior Nucleus of the Thalamus for Refractory Epilepsy.

Background and objectives: Deep brain stimulation (DBS) has developed into an effective therapy for several disease states including treatment-resistant Parkinson disease and medically intractable essential tremor, as well as segmental, generalized and cervical dystonia, and obsessive-compulsive disorder (OCD). Dystonia and OCD are approved with Humanitarian Device Exemption. In addition, DBS is also approved for the treatment of epilepsy in the anterior nucleus of the thalamus. Although overall considered an effective treatment for Parkinson disease and epilepsy, a number of specific factors determine the treatment success for DBS including careful patient selection, effective postoperative programming of DBS devices and accurate electrode placement. Furthermore, invasiveness of the procedure is a rate limiter for patient adoption. It is desired to explore a less invasive way to deliver DBS therapy.

Methods: Here, we report for the first time the direct comparison of endovascular and parenchymal DBS in a triplicate ovine model using the anterior nucleus of the thalamus as the parenchymal target for refractory epilepsy.

Results: Triplicate ovine studies show comparable sensing resolution and stimulation performance of endovascular DBS with parenchymal DBS.

Conclusion: The results from this feasibility study opens up a new frontier for minimally invasive DBS therapy.

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来源期刊
Operative Neurosurgery
Operative Neurosurgery Medicine-Neurology (clinical)
CiteScore
3.10
自引率
13.00%
发文量
530
期刊介绍: Operative Neurosurgery is a bi-monthly, unique publication focusing exclusively on surgical technique and devices, providing practical, skill-enhancing guidance to its readers. Complementing the clinical and research studies published in Neurosurgery, Operative Neurosurgery brings the reader technical material that highlights operative procedures, anatomy, instrumentation, devices, and technology. Operative Neurosurgery is the practical resource for cutting-edge material that brings the surgeon the most up to date literature on operative practice and technique
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