High-frequency unilateral thalamic stimulation in the treatment of essential and parkinsonian tremor
High-frequency unilateral thalamic stimulation in the treatment of essential and parkinsonian tremor
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DOI：
10.1002/ana.410420304
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发表时间：
1997-09-01
影响因子：
11.2
通讯作者：
Olanow, CW
中科院分区：
文献类型：
--
作者：
Koller, W;Pahwa, R;Olanow, CW
原发性震颤和帕金森氏症震颤的药物治疗往往不足。立体定向手术，如丘脑切开术，可以有效地减少震颤。我们对29名特发性震颤患者和24名帕金森病患者进行了一项多中心试验，采用单侧高频刺激丘脑腹正中核，在手术后3个月采用盲法评估，比较震颤的临床评分，刺激开、刺激关和基线，并进行了1年随访。SLP患者因术中缺乏震颤抑制（2例）、出血（2例）、撤回同意（1例）和持续小丘脑切除术效果（1例）而未植入SLP，刺激对侧原发性和帕金森性震颤均显著减少，患者报告残疾显著减少，原发性震颤患者的功能测量显着改善。植入患者的手术并发症很少。刺激通常与短暂性感觉异常有关。其他不良反应轻微且耐受性良好。1)耳时疗效未降低。慢性高频刺激在改善原发性和帕金森性震颤方面是安全有效的。
Pharmacologic treatment for essential tremor and the tremor of Parkinson's disease is often inadequate. Stereotaxic surgery, such as thalamotomy, can effectively reduce tremors. We performed a multicenter trial of unilateral high-frequency stimulation of the ventral intermedius nucleus of the thalamus in 29 patients with essential tremor and 24 patients with Parkinson's disease, using a blinded assessment at 3 months after surgery to compare clinical rating of tremor with stimulation ON with stimulation OFF and baseline and a I-year follow-up. SLP patients were not implanted because of lack of intraoperative tremor suppression (2 patients), hemorrhage (2 patients), withdrawal of consent (1 patient), and persistent microthalamotomy effect (1 patient), A significant reduction in both essential and parkinsonian tremor occurred contralaterally with stimulation, Patients reported a significant reduction in disability, Measures of function were significantly improved in patients with essential tremor. Complications related to surgery in implanted patients were few. Stimulation was commonly associated with transient paresthesias. Other adverse effects were mild and well tolerated. Efficacy was not reduced at 1) ear. Chronic high-frequency stimulation is safe and highly effective in ameliorating essential and parkinsonian tremor.