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Effects of bilateral subthalamic nucleus deep brain stimulation on motor symptoms in Parkinson’s disease: a retrospective cohort study

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Neural Regeneration Research 2021年第5期16卷 905-909页

作者： Guo-Xiong Cheng Shu-Bin Yin Ying-Hao Yang Yuan-Hu Hu Chih-Yang Huang Qian-Ming Yao Wei-Jen Ting Deparment of Neurosurgery The First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdong ProvinceChina Deparment of Neurosurgery The Sixth Affiliated Hospital of Guangzhou Medical UniversityQingyuanGuangdong ProvinceChina Graduate Institute of Basic Medical Science China Medical UniversityTaichungTaiwanChina Department of Health and Nutrition Biotechnology Asia UniversityTaichungTaiwanChina College of Medicine Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationTzu Chi UniversityHualienTaiwanChina Medical Research Center for Exosome and Mitochondria Related Diseases China Medical University and HospitalTaichungTaiwanChina

deep brain stimulation of the bilateral subthalamic nucleus(STN)is a therapeutic option for patients with Parkinson’s disease(PD)in whom medical therapies have been *** retrospective cohort study analyzed the motor function of 27 patients with advanced PD,from the First Affiliated Hospital of Guangzhou Medical University,China,who received deep brain stimulation of the bilateral subthalamic nucleus and evaluated its therapeutic *** 10-year follow-up data of patients was analyzed in Qingyuan People’s Hospital,Sixth Affiliated Hospital of Guangzhou Medical University,*** follow-up data were divided into two categories based on patients during levodopa treatment(on-medication)and without levodopa treatment(off-medication).Compared with baseline,the motor function of onmedication PD patients improved after deep brain stimulation of the bilateral subthalamic *** 2 years later,the motor function of off-medication PD patients had ***-medication PD patients exhibited better therapeutic effects over the 5 years than offmedication PD ***-medication patients’akinesia,speech,postural stability,gait,and cognitive function worsened only after 5 *** results suggest that the motor function of patients with advanced PD benefitted from treatment with deep brain stimulation of the bilateral subthalamic nucleus over a period up to 5 *** overall therapeutic effects were more pronounced when levodopa treatment was combined with deep brain stimulation of the bilateral subthalamic *** study was approved by Institutional Review Board of Qingyuan People’s Hospital,The Sixth Affiliated Hospital of Guangzhou Medical University,China(approval ***-IRB-A0140)on January 11,2018.

关键词： clinical trial deep brain stimulation dopamine dyskinesia levodopa long-term follow-up neurological function Parkinson’s disease thalamus UPDRS

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Effect of deep brain stimulation on substantia nigra neurons in a rat model of Parkinson＇s disease

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Chinese Medical Journal 2012年第22期125卷 4072-4075页

作者： WU Sheng-tian MA Yu ZHANG Kai ZHANG Jian-guo Capital Med Univ Dept Neurosurg Beijing Tiantan Hosp Beijing 100050 Peoples R China Beijing Neurosurg Inst Beijing 100050 Peoples R China

Background Parkinson＇s disease （PD） is a common neurodegenerative disease, which occurs mainly in the elderly. Recent studies have demonstrated that apoptosis plays an important role in the occurrence and development of PD. Subthalamic nucleus deep brain stimulation （STN-DBS） has been recognized as an effective treatment for PD. Recent clinical observations have shown that STN-DBS was able to delay early PD progression, and experiments in animal models have also demonstrated a protective effect of STN-DBS on neurons. However, the correlation between the neuron-protective effect of STN-DBS and the progression of substantia nigra pars compacta （SNc） neuronal apoptosis is still unknown. The aim of this study was to investigate the protective effect and potential mechanism of STN-DBS on SNc neurons in PD rats. Methods After the establishment of a PD rat model by unilateral/2-point injection of 6-hydroxydopamine in the medial forebrain bundle of the brain, DBS by implanting electrodes in the STN was administered. Behavioral changes were observed, and morphological changes of SNc neurons were analyzed by Nissl staining and DNA in situ end-labeling. Through extracellular recording of single neuron discharges and microelectrophoresis, the causes of and changes in SNc excitability during STN-DBS were analyzed, and the protective effect and potential mechanism of action of STN-DBS on SNc neurons in PD rats was investigated. Results SNc neuron apoptosis was significantly decreased （P 〈0.05） in the stimulation group, compared with the sham stimulation PD group. Spontaneous discharges of SNc neurons were observed in normal rats and PD model rats, and the mean frequency of spontaneous discharges of SNc neurons in normal rats （（40.65＋11.08） Hz） was higher than that of residual SNc neurons in PD rats （（36.71＋9.23） Hz）. Electrical stimulation of the STN in rats was associated with elevated excitation in unilateral SNc neurons. However, administering the gamma-aminobutyric acid recep

关键词： Parkinson's disease apoptosis deep brain stimulation excitatory neurotransmitter

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Forniceal deep brain stimulation in severe Alzheimer's disease:A case report

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World Journal of Clinical Cases 2020年第20期8卷 4938-4945页

作者： Wei Lin Wei-Qi Bao Jing-Jie Ge Li-Kun Yang Zhi-Pei Ling Xin Xu Jie-Hui Jiang Chuan-Tao Zuo Yu-Hai Wang Department of Neurosurgery Joint Logistics Support Unit No.904 HospitalWuxi 214044Jiangsu ProvinceChina PET Center Huashan HospitalFudan UniversityShanghai 200235China Department of Neurosurgery PLA General HospitalPLA Postgraduate Medical SchoolBeijing 100039China School of Communication and Information Technology Institute of Biomedical EngineeringShanghai UniversityShanghai 200444China

BACKGROUND Forniceal deep brain stimulation(DBS)has been proposed as an alternative treatment for Alzheimer's disease(AD).Previous studies on mild to moderate AD patients demonstrated improvements in cognitive functions brought about by forniceal ***,we report our longitudinal findings in one severe AD patient for whom the activities of daily living(ADL)rather than cognitive function significantly improved after 3 mo of continuous *** SUMMARY In 2011,a 62-year-old Chinese male with no previous history of brain injury or other neuropsychological diseases and no family history of dementia developed early symptoms of memory decline and cognitive *** years later,the symptoms had increased to the extent that they affected his daily *** lost the ability to work as a businessman and to take care of *** patient was given a clinical diagnosis of probable AD and was prescribed donepezil and subsequently memantine,but no improvement in symptoms was *** patient then received DBS *** 3 mo of continuous stimulation,the patient's ADL score decreased from 65 points to 47 points,indicating the quality of the patient's daily living improved *** scores remained unchanged,suggesting no significant improvement in cognitive function.A follow-up positron emission tomography scan demonstrated perceivable increased glucose metabolism in the classical AD-related brain *** Based on this case we hypothesize that forniceal DBS may improve ADL through elevating regional glucose metabolism in the brain.

关键词： deep brain stimulation Alzheimer's disease Fluorodeoxy glucose Positron emission tomography Activities of daily living Case report

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Internal Pallidum and Subthalamic Nucleus deep brain stimulation for Oromandibular Dystonia

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Chinese Medical Journal 2016年第13期129卷 1619-1620页

作者： Xue-Min Zhao Jian-Guo Zhang Fan-Gang Meng Department of Functional Neurosu rgery Beijing Neurosurgical Institute Capital Medical University Beijing 100050 China Beijing Key Laboratory of Neuromodulation Beijing Municipal Science and Technology Commission Beijing 100050 China Department of Neurosurgery Beijing Tiantan Hospital Capital Medical University Beijing 100050 China

Dystonia is a neurologic disorder characterized by sustained involuntary movements or abnormal posture. Oromandibular dystonia is a form of focal dystonia that is characterized by forceful contractions of face, jaw, o... 详细信息

关键词： deep brain stimulation Globus Paliidus Intemus Oromandibular Dystonia Subthalamic Nucleus

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Application of Preoperative CT/MRI Image Fusion in Target Positioning for deep brain stimulation

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Chinese Medical Sciences Journal 2016年第3期31卷 161-167页

作者： Yu Wang Zi-yuan Liu Wan-chen Dou Wen-bin Ma Ren-zhi Wang Yi Guo Department of Neurosurgery Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical College

Objective To explore the efficacy of target positioning by preoperative CT/MRI image fusion technique in deep brain *** We retrospectively analyzed the clinical data and images of 79 cases(68 with Parkinson's disease,11 with dystonia) who received preoperative CT/MRI image fusion in target positioning of subthalamic nucleus in deep brain *** of implanted electrodes from the target nucleus of each patient were *** evaluations of each patient before and after the treatment were performed and *** of the positioning and treatment were *** The mean deviations of the electrodes implanted on X,Y,and Z axis were 0.5 mm,0.6 mm,and 0.6 mm,*** neurologic evaluations scores of unified Parkinson's disease rating scale(UPDRS) for Parkinson's disease and Burke-Fahn-Marsden Dystonia Rating Scale(BFMDRS) for dystonia patients improved significantly compared to the preoperative scores(Pdeep brain stimulation has high accuracy and good clinical outcomes.

关键词： deep brain stimulation image fusion magnetic resonance imaging computed tomography Parkinson's disease dystonia

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Parkinsonism-hyperpyrexia syndrome after withdrawal of antiparkinsonian drugs and deep brain stimulation surgery

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Chinese Neurosurgical Journal 2017年第2期3卷 123-126页

作者： ChunLei Han Yan Ge DaWei Meng JianGuo Zhang FanGang Meng Department of Neurosurgery Second Affiliated Hospital of Wenzhou Medical University 109 Xueyuan Western Road Wenzhou Zhejiang 325027China Department of Neurosurgery Ningbo No.2 Hospital Ningbo China Department of Neurosurgery First Affiliated Hospital of Medical College of Xi'an Jiaotong University Xi'an China

Background:Parkinsonism-hyperpyrexia syndrome (PHS) is a rare but potentially fatal condition in patients with Parkinson's *** brain stimulation (DBS) is a widely used and efficacious treatment for advanced Parkinson's *** presentation:Here,we report a case of PHS in a patient who first underwent withdrawal of antiparkinsonian medications and then bilateral subthalamic nucleus ***:Patients should be advised to gradually decrease rather than suddenly stop antiparkinsonian medications when they must stop taking a medication and antiparkinsonian medications should be reintroduced as soon as possible after surgery.

关键词： Parkinson's disease deep brain stimulation Parkinsonism-hyperpyrexia syndrome

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Could cough be an intraoperative indicator for venous air embolism in deep brain stimulation surgeries?: experiences from a large case series

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Chinese Neurosurgical Journal 2016年第4期2卷 194-200页

作者： Lin Shi Chao-Cai Zhang Jun-Ju Li Guan-Yu Zhu Ying-Chuan Chen Jian-Guo Zhang Department of Neurosurgery Beijing Tiantan Hospital Capital Medical University Beijing China Department of Neurosurgery People's Hospital of Hainan Province Haikou Hainan China Department of Neurosurgery

Background:deep brain stimulation (DBS) surgery is usually performed with the patients located in a half-sitting ***,complications associated with such position accompany,such as venous air embolism (VAE),et ***,because the patients are fully conscious during the surgery,they may have observable manifestations related to the complications that are otherwise inconspicuous in generally anesthetic ***,we designed this study to investigate the intraoperative manifestations of the potentially dangerous complication of VAE in the DBS ***:The medical records of a series of 705 consecutive patients who underwent DBS surgery in our hospital have been retrospectively *** clinical features,intraoperative manifestations and treatment of these patients were analyzed for evidence of *** correlation between the cough intensity and other clinical features were ***:Evidence of VAE were found in 16 *** analyses showed that severe cough is associated with greater age (p =0.045),longer coughing time (p =0.001),more intensive tremor (p =0.032),more complaints (p =0.036),greater influences (p =0.009),more treatment (p =0.003) and longer hospitalization (p =0.003).Conclusions:Intraoperative intense and unremitting cough may be a noticeable indicator of possible *** recognition and effective management are essential to prevent unfavorable outcomes in such cases.

关键词： deep brain stimulation Venous air embolism Cough Clinical features

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Subthalamic nucleus deep brain stimulation for Parkinson’s disease: 8 years of follow-up

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Translational Neurodegeneration 2013年第1期2卷 68-71页

作者： Dianyou Li Chunyan Cao Jing Zhang Shikun Zhan Shengdi Chen Bomin Sun Department of Functional Neurosurgery Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200025China Department of Neurology Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200025China

Objective:The short-term benefits of bilateral stimulation of the subthalamic nucleus(STN)in patients with advanced Parkinson’s disease(PD)are well documented,but long-term benefits are still *** aim of this study is to evaluate the outcome of 8 years of bilateral STN stimulation to PD ***:In this study,31 consecutive PD patients were treated with bilateral STN *** functional status was measured using the Activities of Daily Living section of the Unified Parkinson’s Disease Rating Scale(UPDRS-ADL)at drug on(with medication)and drug off(without medication)states preoperatively and at 1,5,and 8 years *** addition,Levodopa equivalent doses and stimulation parameters were also ***:After 8 years of STN stimulation,the UPDRS-ADL scores were improved by 4%at drug off status(P>0.05)and 22%at drug on status(Pstimulation voltage and pulse width were not changed,but the stimulation frequency was decreased remarkably compared with the 5 years of *** events were observed in 6 patients,including misplacement of the electrode and skin erosion requiring further *** events were resolved without permanent sequelae.2 patients died of aspiration pneumonia 6 and 7 years after ***:The marked improvement in UPDRS-ADL scores were still observed after 8 years of bilateral STN stimulation with medication.

关键词： deep brain stimulation Long-term effects Parkinson’s disease Subthalamic nucleus

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Post subthalamic area deep brain stimulation for tremors:a mini-review

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Translational Neurodegeneration 2012年第1期1卷 159-166页

作者： Tao Xie Jacqueline Bernard Peter Warnke Department of Neurology University of Chicago Medical CenterChicagoIL 60637USA Department of Neurosurgery University of Chicago Medical CenterChicagoIL 60637USA

deep brain stimulation(DBS)in the thalamic ventrointermediate nucleus(VIM)is the traditional target for the surgical treatment of pharmacologically refractory essential tremor or parkinsonian *** in recent years on DBS in posterior subthalamic area(PSA),including the zona incerta and the prelemniscal radiation,have shown promising results in tremor suppression,particularly for those tremors difficult to be well controlled by VIM DBS,such as the proximal postural tremor,distal intention tremor and some cerebellar outflow tremor in various diseases including essential tremor and multiple *** adverse effect profile of the PSA DBS is mild and transient,without lasting or striking dysarthria,disequilibrium or tolerance,in contrast to VIM DBS,particularly bilateral ***,the studies on PSA DBS so far are still limited,with a handful of studies on bilateral PSA,and a short follow up duration compared to *** studies are needed for direct comparison of these targets in the future.A review here would help to gain more insight into the benefits and limits of the PSA DBS compared to that in VIM in the clinical management of various tremors,particularly for those difficult to be well controlled by traditional VIM DBS.

关键词： Post subthalamic area Zona incerta deep brain stimulation Tremor

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Nursing, Psychological Intervention and Self-Management after deep brain stimulation in Parkinson’s Disease

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Journal of Behavioral and brain Science 2020年第12期10卷 517-530页

作者： Lizhen Wu Yajuan Ke Yunwan Chen Fangtan Xing Yanman Chen Hainan General Hospital Haikou China

Parkinson’s disease (PD) is a neurodegenerative disease mainly caused by motor disorders, mostly occurring in middle-aged and elderly people. The incidence of PD has been increasing year by year, and up to now, PD is still an incurable disease. However, more and more data show that early implementation of deep brain stimulation and early medical, psychological, social and other interventions can significantly improve the quality of life and prolong the survival time of patients with Parkinson’s disease (PD). Mental health guidance, cognitive behavioral intervention, psychogenic therapy and scientific nursing for PD patients may improve the functional recovery after deep brain stimulation (DBS) for Parkinson’s disease. This paper discusses the nursing and psychological intervention methods of deep brain stimulation (DBS) implantation in patients with Parkinson’s disease (PD), aiming to scientifically discuss the clinical effect of nursing psychological intervention and improve the quality of life in patients with Parkinson’s disease. Basic nursing and psychological cognitive behavior intervention measures for PD patients can improve the daily activity ability of PD patients, improve the outcome of PD patients, and effectively improve the satisfaction of PD patients with nursing work, which has certain clinical promotion significance.

关键词： Parkinson’s Disease deep brain stimulation Nursing Psychological Intervention

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