PDF(Pubmed)
Abstract：
UNASSIGNED: Subthalamic nucleus (STN) and globus pallidus interna (GPi) are two main structures primarily targeted by deep brain stimulation (DBS) to treat advanced Parkinson\'s disease (PD). A subset of cases with unsatisfactory outcomes may benefit from rescue DBS surgery targeting another structure, while these patients\' characteristics have not been well described and this phenomenon has not been well reviewed.
UNASSIGNED: This monocentric retrospective study included patients with PD, who underwent rescue STN DBS following an unsatisfactory outcome of the initial bilateral GPi DBS in a retrospective manner. A short review of the current literature was conducted to report the clinical outcome of rescue DBS surgeries.
UNASSIGNED: Eight patients were identified, and six of them were included in this study. The rescue STN DBS was performed 19.8 months after the initial GPi DBS. After 8.8 months from the rescue STN DBS, patients showed a significant off-medication improvement by 29.2% in motor symptoms compared to initial GPi DBS. Non-motor symptoms and the health-related quality of life were also significantly improved.
UNASSIGNED: Our findings suggest that the rescue STN DBS may improve off-medication motor and non-motor symptoms and quality of life in patients with failure of initial GPi DBS. The short review of the current literature showed that the target switching from GPi to STN was mainly due to poor initial outcomes and was performed by target substitution, whereas the switching from STN to GPi was mainly due to a gradual waning of benefits, long-term axial symptoms, dyskinesia, and dystonia and was performed by target addition.
UNASSIGNED: This monocentric retrospective study included patients with PD, who underwent rescue STN DBS following an unsatisfactory outcome of the initial bilateral GPi DBS in a retrospective manner. A short review of the current literature was conducted to report the clinical outcome of rescue DBS surgeries.
UNASSIGNED: Eight patients were identified, and six of them were included in this study. The rescue STN DBS was performed 19.8 months after the initial GPi DBS. After 8.8 months from the rescue STN DBS, patients showed a significant off-medication improvement by 29.2% in motor symptoms compared to initial GPi DBS. Non-motor symptoms and the health-related quality of life were also significantly improved.
UNASSIGNED: Our findings suggest that the rescue STN DBS may improve off-medication motor and non-motor symptoms and quality of life in patients with failure of initial GPi DBS. The short review of the current literature showed that the target switching from GPi to STN was mainly due to poor initial outcomes and was performed by target substitution, whereas the switching from STN to GPi was mainly due to a gradual waning of benefits, long-term axial symptoms, dyskinesia, and dystonia and was performed by target addition.
摘要：
■丘脑底核（STN）和苍白球（GPi）是两个主要结构，主要是通过深部脑刺激（DBS）治疗晚期帕金森病（PD）。结果不令人满意的病例的子集可能受益于针对另一个结构的救援DBS手术。虽然这些患者的特征没有得到很好的描述，这种现象也没有得到很好的评价。
■这项单中心回顾性研究包括PD患者，在回顾性分析初始双侧GPiDBS结果不满意后接受了STNDBS的抢救。对当前文献进行了简短回顾，以报告抢救DBS手术的临床结果。
■确定了8名患者，其中6人被纳入本研究。在初始GPiDBS后19.8个月进行救援STNDBS。在救援STNDBS8.8个月后，与最初的GPiDBS相比,患者的运动症状在非药物治疗方面显著改善29.2%.非运动症状和健康相关生活质量也显著改善。
■我们的研究结果表明，抢救STNDBS可以改善初始GPiDBS失败的患者的非药物运动和非运动症状以及生活质量。对当前文献的简短回顾表明，从GPi到STN的目标转换主要是由于不良的初始结果，并且通过目标替代进行，而从STN到GPI的转换主要是由于利益的逐渐减少，长期轴性症状，运动障碍,和肌张力障碍，并通过目标添加进行。
■这项单中心回顾性研究包括PD患者，在回顾性分析初始双侧GPiDBS结果不满意后接受了STNDBS的抢救。对当前文献进行了简短回顾，以报告抢救DBS手术的临床结果。
■确定了8名患者，其中6人被纳入本研究。在初始GPiDBS后19.8个月进行救援STNDBS。在救援STNDBS8.8个月后，与最初的GPiDBS相比,患者的运动症状在非药物治疗方面显著改善29.2%.非运动症状和健康相关生活质量也显著改善。
■我们的研究结果表明，抢救STNDBS可以改善初始GPiDBS失败的患者的非药物运动和非运动症状以及生活质量。对当前文献的简短回顾表明，从GPi到STN的目标转换主要是由于不良的初始结果，并且通过目标替代进行，而从STN到GPI的转换主要是由于利益的逐渐减少，长期轴性症状，运动障碍,和肌张力障碍，并通过目标添加进行。
