帕金森病眼下丘脑下深部脑刺激围手术期戈里桑的影响

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-10-28 DOI:10.1002/brb3.70069

Hiroyuki Kajikawa, Keita Matsuura, Yuichiro Ii, Ken-ichi Tabei, Naoko Nakamura, Hidehiro Ishikawa, Yamato Nishiguchi, Kana Matsuda, Ken Kagawa, Naoki Ichikawa, Tomohiro Araki, Akihiro Shindo

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引用次数: 0

摘要

导言：帕金森病（PD）患者可从脑深部刺激（DBS）中获益。DBS 术后有时会出现病灶周围脑水肿，但这是一过性的，不会影响最终预后。有报道称，额叶水肿患者在术后第一周会出现认知功能的短暂恶化。本研究旨在探讨戈瑞桑对预防 DBS 术后水肿变化的作用，并确定水肿对认知功能的影响：我们纳入了29名接受双侧丘脑下核（STN）DBS手术的帕金森病患者，并将其分为两组：使用歌礼散的患者（11名）和未使用歌礼散的患者（18名）。术后 1 周，所有患者均接受了磁共振成像检查。我们在流体增强反转恢复（FLAIR）图像上测量了额叶白质或 STN 的水肿体积。最后，比较了有戈瑞桑和无戈瑞桑两组患者的脑水肿、运动功能和认知功能：结果：在术后 1 周的 FLAIR 图像中，使用戈瑞桑的组的术后额叶皮质下水肿（FE）平均体积明显低于未使用戈瑞桑的组（分别为 2249 ± 2186 mm3、6261 ± 7213 mm3，P = 0.023）。以年龄、术前迷你精神状态检查（MMSE）评分、FE和STN周围水肿（SE）为因素，术后1周的MMSE为因变量的多变量分析显示，术前MMSE评分和SE是重要的相关因素：结论：DBS手术后的FE可通过使用戈瑞桑得到缓解。SE和术前MMSE评分与术后1周的MMSE评分相关：试验注册：不适用。

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Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's Disease

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Effects of Goreisan in the Perioperative Period of Subthalamic Deep Brain Stimulation in Parkinson's Disease

Introduction

Patients with Parkinson's disease (PD) may benefit from deep brain stimulation (DBS). Perifocal brain edema sometimes occurs after DBS surgery, but it is transient and does not affect the final prognosis. Transient deterioration of cognitive function has been reported in patients with frontal edema in the first postoperative week. This study aimed to investigate the effect of Goreisan in preventing edematous changes after DBS and determine the influence of edema on cognition.

Methods

We included 29 patients with PD who underwent bilateral subthalamic nucleus (STN) DBS and who were divided into 2 groups: those using (11 patients) and those not using Goreisan (18 patients). At 1 week postoperatively, all patients underwent magnetic resonance imaging. We measured the volume of edema either in the frontal white matter or STN on fluid-attenuated inversion recovery (FLAIR) images. Finally, brain edema, motor function, and cognitive function were compared between the groups with and without Goreisan.

Results

In the FLAIR image 1 week postoperatively, the average postoperative frontal subcortical edema (FE) volume of the group with Goreisan was significantly lower than that without Goreisan (2249 ± 2186 mm³, 6261 ± 7213 mm³, respectively, p = 0.023). Multivariate analysis with age, preoperative Mini-Mental State Examination (MMSE) score, FE, and peri-STN edema (SE) as factors, and MMSE at 1 week postoperatively as the dependent variable showed that preoperative MMSE score and SE were significant as associated factors.