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IF 3.5 2区医学 Q1 CLINICAL NEUROLOGY

Journal of neurosurgery Pub Date : 2025-03-14 DOI:10.3171/2024.12.JNS241739

Zhebin Feng, Bin Liu, Junpeng Xu, Yanyang Zhang, Zhipei Ling, Xin Xu, Zhiguo Ma, Xinguang Yu, Zhiqi Mao

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引用次数: 0

摘要

目的：眼下核深部脑刺激（STN-DBS）治疗原发性梅杰综合征的报道近年来越来越多。尽管这种治疗方法很有潜力，但只有少数研究对其临床疗效进行了评估。此外，STN-DBS 对不同梅杰综合征患者的疗效也不尽相同，稳定的预后预测指标也很少。在这项研究中，作者评估了 STN-DBS 对梅杰综合征的治疗效果，并探索了可靠的预后指标，以帮助选择患者和制定术后方案：作者连续招募了65名在其所在机构接受双侧STN-DBS手术的梅杰综合征患者。使用伯克-法恩-马斯登肌张力障碍评定量表运动（BFMDRS-M）和残疾（BFMDRS-D）分量表评估术前和术后运动症状。使用导联-DBS 工具箱在标准空间中重建导联，并计算每个导联的激活组织体积（VTA）。进行了分组比较和多变量逻辑回归分析，以评估影响 BFMDRS-M 评分改善率的临床和人口学因素：观察到术后BFMDRS-M评分（59.17% ± 28.0%，p < 0.001）和BFMDRS-D评分（65.05% ± 38.9%，p < 0.001）显著改善。分组比较表明，活动触点的y轴值、VTA与STN感觉运动区的重叠体积以及活动触点中心到STN感觉运动区表面的距离与BFMDRS-M评分的改善率显著相关。多变量逻辑回归分析显示，VTA与双侧STN感觉运动区的重叠体积以及左侧STN边缘区的受累程度是BFMDRS-M评分改善的独立预后指标：双侧 STN-DBS 被证明是治疗梅杰综合征的一种安全有效的方法，而 STN 感觉运动区往往是理想的靶区。该研究为 STN-DBS 治疗梅杰综合征的临床疗效、患者选择和靶点精确性提供了更深入的见解。

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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Clinical outcomes and prognostic factors in patients with primary Meige syndrome undergoing subthalamic nucleus deep brain stimulation: a retrospective study of 65 cases.

Objective: Subthalamic nucleus deep brain stimulation (STN-DBS) for primary Meige syndrome has been increasingly reported in recent years. Despite the potential of this therapeutic approach, only a limited number of studies have evaluated its clinical benefits. Moreover, the efficacy of STN-DBS varies among patients with Meige syndrome, and stable prognostic predictors are scarce. In this study, the authors assessed the therapeutic effect of STN-DBS for Meige syndrome and explored reliable prognostic indicators to facilitate patient selection and postoperative programming.

Methods: The authors enrolled 65 consecutive patients with Meige syndrome who underwent bilateral STN-DBS at their institution. Preoperative and postoperative motor symptoms were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale movement (BFMDRS-M) and disability (BFMDRS-D) subscales. Leads were reconstructed in the standard space by using the Lead-DBS toolbox, and the volume of tissue activated (VTA) was calculated for each lead. Group comparisons and multivariate logistic regression analyses were conducted to evaluate clinical and demographic factors influencing the improvement rates in BFMDRS-M scores.

Results: Significant postoperative improvements in the BFMDRS-M score (59.17% ± 28.0%, p < 0.001) and in the BFMDRS-D score (65.05% ± 38.9%, p < 0.001) were observed. Group comparisons indicated that the y-axis value of active contacts, the overlapping volume between VTAs and the STN sensorimotor region, as well as the distance from the center of active contacts to the surface of the STN sensorimotor region were significantly associated with the improvement rate of BFMDRS-M scores. Multivariate logistic regression analyses revealed that both the overlapping volume between VTAs and bilateral STN sensorimotor regions-along with the involvement of the left STN limbic region-emerged as independent prognostic indicators for the improvement in BFMDRS-M scores.

Conclusions: Bilateral STN-DBS proved to be a safe and effective treatment for Meige syndrome, and the STN sensorimotor region tended to be a desirable target. This study provided deeper insights into the clinical efficacy, patient selection, and targeting precision of STN-DBS treatment for Meige syndrome.

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来源期刊

Journal of neurosurgery 医学-临床神经学

CiteScore

7.20

自引率

7.30%

发文量

1003

审稿时长

1 months

期刊介绍： The Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of Neurosurgery: Pediatrics, and Neurosurgical Focus are devoted to the publication of original works relating primarily to neurosurgery, including studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology. The Editors and Editorial Boards encourage submission of clinical and laboratory studies. Other manuscripts accepted for review include technical notes on instruments or equipment that are innovative or useful to clinicians and researchers in the field of neuroscience; papers describing unusual cases; manuscripts on historical persons or events related to neurosurgery; and in Neurosurgical Focus, occasional reviews. Letters to the Editor commenting on articles recently published in the Journal of Neurosurgery, Journal of Neurosurgery: Spine, and Journal of Neurosurgery: Pediatrics are welcome.