Deep Brain Stimulation of Pedunculopontine Nucleus for Postural Instability and Gait Disorder After Parkinson Disease: A Meta-Analysis of Individual Patient Data.
Deep Brain Stimulation of Pedunculopontine Nucleus for Postural Instability and Gait Disorder After Parkinson Disease: A Meta-Analysis of Individual Patient Data.
复制标题
脑深部刺激桥脚核治疗帕金森病后姿势不稳和步态障碍：个体患者数据的荟萃分析。
DOI：
10.1016/j.wneu.2017.02.110
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发表时间：
2017-06
期刊：
影响因子：
--
通讯作者：
Li Yong-Jie
中科院分区：
文献类型：
--
作者：
Wang Jia-Wei;Zhang Yu-Qing;Zhang Xiao-Hua;Wang Yun-Peng;Li Ji-Ping;Li Yong-Jie
背景帕金森病（Parkinson disease，PD）患者的姿势不稳定和步态障碍（Postural instability and gait disorder，PIGD）与PD的主要发病率和死亡率密切相关，一直是临床治疗的一大难题。桥脚核（PPN）被认为是脑深部电刺激（DBS）治疗PIGD的潜在靶点。对个别患者的数据进行荟萃分析，以评估PPN DBS对PD患者PIGD的影响，并探讨预测良好outcome.MethodsAccording研究策略的因素，我们搜索PubMed，Embase，和科克伦中央注册对照试验，和其他来源。检索文献后，由2名研究者独立筛选文献，评估纳入试验的质量，并提取数据。结局指标包括PIGD、步态冻结和PD跌倒。然后，个别患者的数据被纳入SPSS软件进行统计分析，跨series.ResultsSix研究报告个别患者的数据被纳入最终分析。PPN DBS显著改善了PIGD以及PD后步态冻结和跌倒，这取决于随访持续时间和结局指标类型。此外，患者的年龄，病程，左旋多巴等效剂量，并选择单侧或双侧刺激与PD患者组或不改善PIGD后PPN DBS.ConclusionsOur研究提供的证据表明，PPN DBS可能会改善PIGD，这应谨慎解释，并需要进一步验证，然后再概括我们的结果。
BackgroundPostural instability and gait disorder (PIGD) in Parkinson disease (PD) has been a great challenge in clinical practice because PIGD is closely linked to major morbidity and mortality in PD. Pedunculopontine nucleus (PPN) has been considered as a potential promising target for deep brain stimulation (DBS) in the treatment of PIGD. A meta-analysis of individual patient data was performed to assess the effects of PPN DBS on PIGD in patients with PD and explore the factors predicting good outcome.MethodsAccording to the study strategy, we searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials, and other sources. After searching the literature, 2 investigators independently screened the literature, assessed the quality of the included trials, and extracted the data. The outcome measures included PIGD, freezing of gait, and falling in PD. Then, individual patient data were incorporated into SPSS software for statistical analyses across series.ResultsSix studies reporting individual patient data were included for final analysis. PPN DBS significantly improved PIGD as well as freezing of gait and falling after PD, which was depending on the duration of follow-up and types of outcome measures. In addition, patient age, disease duration, levodopa-equivalent dosage, and the choice of unilateral or bilateral stimulation were similar in groups of patients with PD with or without improvement in PIGD after PPN DBS.ConclusionsOur study provides evidence that PPN DBS may improve PIGD, which should be interpreted with caution and needs further verification before making generalization of our results.
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影响因子：
2.2
作者：
Quintanilha Ribeiro, Fernando de Andrade
通讯作者：
Quintanilha Ribeiro, Fernando de Andrade
影响因子：
--
作者：
Bronstein JM;Tagliati M;Alterman RL;Lozano AM;Volkmann J;Stefani A;Horak FB;Okun MS;Foote KD;Krack P;Pahwa R;Henderson JM;Hariz MI;Bakay RA;Rezai A;Marks WJ Jr;Moro E;Vitek JL;Weaver FM;Gross RE;DeLong MR
通讯作者：
DeLong MR
影响因子：
14.5
作者：
Lau, Brian;Welter, Marie-Laure;Karachi, Carine
通讯作者：
Karachi, Carine
DOI：
10.1176/jnp.14.2.223
发表时间：
2002
期刊：
The Journal of neuropsychiatry and clinical neurosciences
影响因子：
--
作者：
J. Parkinson
通讯作者：
J. Parkinson
影响因子：
14.5
作者：
Ferraye, M. U.;Debu, B.;Pollak, P.
通讯作者：
Pollak, P.