Efficacy, stability and predictors of outcome of pallidotomy for Parkinson's disease - Six-month follow-up with additional 1-year observations
Efficacy, stability and predictors of outcome of pallidotomy for Parkinson's disease - Six-month follow-up with additional 1-year observations
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DOI：
10.1093/brain/120.5.729
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发表时间：
1997-05-01
期刊：
影响因子：
14.5
通讯作者：
Calne, DB
中科院分区：
文献类型：
--
作者：
Kishore, A;Turnbull, IM;Calne, DB
我们测试了用于治疗药物治疗 (IP) 控制不佳的帕金森病患者的单侧苍白球切开术的疗效、稳定性和结果预测因素。手术过程尽可能简单；我们使用 CT 而不是 MRI，并且省略了微电极记录。我们研究了 24 名 IP 患者；其中 22 名患者患有药物引起的运动障碍。在关闭（药物治疗）状态下，对侧的所有主要帕金森运动体征都有显着且稳定的改善。在ON（药物治疗）状态下，对侧鼻峰运动障碍得到缓解。同侧唯一显着且稳定的变化是运动障碍的改善不如对侧明显。随着年龄的增长，统一帕金森病评定量表中关闭凝视运动评分的改善也随之增加。总运动障碍评分的改善与年龄无关，但随着疾病持续时间、运动障碍持续时间和运动障碍基线严重程度的增加而增加。五名患者出现暂时性神经系统并发症，而一名患者则出现永久性面瘫。我们的结果与其他使用雾化微电极记录技术进行定位的人获得的结果相似。通过按照我们描述的方式简化程序，该手术可以为更多的患者所采用。
We tested the efficacy, stability and predictors of outcome of unilateral pallidotomy used to treat patients with Parkinson's disease inadequately controlled with pharmacotherapy (IP). The surgical procedure was as simple as possible; we used CT rather than MRI, and we omitted microelectrode recording. We studied 24 patients with IP; 22 of these patients had drug-induced dyskinesias. There was a significant and stable improvement in all the major parkinsonian motor signs in the OFF (medication) state on the contralateral side. In the ON (medication) state peak-nose dyskinesias were alleviated on the contralateral side. The only significant and stable change on the ipsilateral side was improvement in dyskinesias less marked than on the contralateral side. The improvement in Unified Parkinson's Disease Rating Scale motor scores in the OFF stare increased with age. The improvement in total dyskinesia scores occurred irrespective of age, bur increased with duration of disease, duration of dyskinesias and baseline severity of dyskinesias. Five patients had transient neurological complications while facial paresis was permanent in one subject. Our results are similar to those obtained by others who used the rime consuming microelectrode recording technique for localization By simplifying the procedure in the way that we describe, the operation could become available to a greater number of patients.