Deep brain stimulation therapy for a persistent vegetative state.
Deep brain stimulation therapy for a persistent vegetative state.
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针对持续性植物人状态的深部脑刺激疗法。
DOI：
10.1007/978-3-7091-6105-0_18
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
T. Tsubokawa
中科院分区：
文献类型：
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作者：
Takamitsu Yamamoto;Y. Katayama;H. Oshima;C. Fukaya;T. Kawamata;T. Tsubokawa
对20例因各种脑损伤所致的持续性植物状态（PVS）患者，于PVS持续3个月后进行神经和电生理学检查，并进行脑深部电刺激（DBS）治疗。刺激部位为中脑网状结构（2例）和CM-pf复合体（18例）。其中7名患者从PVS中出来，并能够服从口头命令。然而，他们仍然处于卧床不起的状态。这7例病例在连续EEG频率分析中显示去极化或轻微去极化模式。ABR的Vth波和SEP的N20波潜伏期延长后仍能记录到，痛相关P250波振幅大于7 microV。我们的结论是，慢性DBS治疗可能是有用的，让病人从PVS出现，如果候选人根据神经生理学标准进行选择。鉴于从PVS中出现的患者的严重残疾状态，可能需要包括神经刺激治疗在内的特殊康复计划来治疗PVS。
Twenty cases of a persistent vegetative state (PVS) caused by various kinds of brain damage were neurologically and electrophysiologically evaluated at 3 months after persistence of the PVS, and were treated by deep brain stimulation (DBS) therapy. The stimulation sites were the mesencephalic reticular formation (2 cases) and CM-pf complex (18 cases). Seven of the patients emerged from the PVS, and became able to obey verbal commands. However, they remained in a bedridden state. These 7 cases revealed a desynchronization or slight desynchronization pattern on continuous EEG frequency analysis. The Vth wave of ABR and N20 of SEP could be recorded even with a prolonged latency, and the pain-related P250 was recorded with an amplitude of over 7 microV. We conclude that chronic DBS therapy may be useful for allowing the patient to emerge from a PVS, if the candidates are selected according to the neurophysiological criteria. In view of the severely disabled state of the patients who emerged from the PVS, a special rehabilitation program which includes neurostimulation therapy may be necessary for treatment of the PVS.