Predictors for improvement after electroconvulsive therapy in parkinsonian patients with on-off symptoms
Predictors for improvement after electroconvulsive therapy in parkinsonian patients with on-off symptoms
复制标题
具有断断续续症状的帕金森病患者电休克治疗后改善的预测因素
DOI：
10.1007/bf01249604
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发表时间：
2005
影响因子：
3.3
通讯作者：
J. Wålinder
中科院分区：
文献类型：
--
作者：
J. Balldin;A. Granérus;G. Lindstedt;K. Modigh;J. Wålinder
对9例出现“开-关”现象的帕金森病患者进行了电痉挛治疗（ECT）的抗帕金森效果研究。在ECT期间和之后，患者继续使用先前调整剂量的抗帕金森药物。在治疗前后分别评估帕金森病和精神症状。在治疗开始前3天测定血清泌乳素（PRL）和生长激素（GH）的基础水平以及阿波啡诱导的变化（0.24 mg i.v）。5例患者帕金森症状明显改善。另外两名患者略有改善。改善持续2-41周。发现ECT后的改善与治疗时的年龄、左旋多巴治疗的持续时间以及估计的左旋多巴的生活剂量有关。帕金森症状的改善与治疗前精神抑郁评分、GH和PRL的基础血清水平或阿波啡诱导的这些激素水平的变化均无相关性。研究表明，ECT是一种有价值的辅助治疗帕金森病患者的“开-关”现象的选择组。此外，结果支持我们之前的建议，ECT增加突触后多巴胺敏感结构的反应性。
The antiparkinsonian effect of electroconvulsive therapy (ECT) was investigated in nine parkinsonian patients with “on-off” phenomena. The patients were maintained on previously adjusted doses of antiparkinsonian drugs during and after ECT. Parkinsonian as well as mental symptoms were rated before and after treatment.Basal serum levels of prolactin (PRL) and growth hormone (GH) as well as apomorphine induced changes (0.24 mg i.v.) in these levels were investigated three days before start of treatment.Marked improvement of parkinsonian symptoms was seen in five patients. Two further patients showed slight improvement. The improvement persisted for 2–41 weeks. Improvement after ECT was found to correlate with age at the time of treatment and with duration of L-dopa therapy as well as the estimated life-dose of L-dopa. No correlation was found between improvement of parkinsonian symptoms and either scores of mental depression before treatment, basal serum levels of GH and PRL or apomorphine induced changes in these hormone levels. The investigation indicates that ECT is a valuable adjuvant in the treatment of a selected group of parkinsonian patients with “on-off” phenomena. Furthermore, the results support our earlier proposal that ECT increases the responsiveness in postsynaptic dopamine sensitive structures.