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目的 研究双侧丘脑底核 (STN)慢性电刺激术(DBS)对晚期帕金森病 (PD)患者静止期脑局部糖代谢的影响 ,并探讨DBS的作用机制。方法 对 7例进行双侧STNDBS的晚期PD患者 ,在术前和术后 1个月电刺激条件下 ,分别进行 18F -脱氧葡萄糖 (FDG) /PET检查和UPDRS评分 ,并通过SPM99统计学软件进行数据分析 ,研究双侧STNDBS对PD患者脑内代谢的影响。结果 双侧STNDBS使PD患者临床症状明显改善 ,同时脑局部糖代谢也发生了明显变化 :双侧豆状核、脑干 (中脑、脑桥 )、双侧顶枕部、运动前区(BA6 )及扣带回的脑代谢增加 ;前额叶底部、海马的脑代谢减少 (P <0 .0 5 )。结论 双侧STNDBS可能通过兴奋STN轴突的方式 ,使轴突投射区域的基底节上行和下行通路代谢改善 ,并增加相应的额叶高级运动中枢的代谢 ,使PD患者临床症状改善。
Objective To investigate the effect of chronic electrical stimulation of bilateral subthalamic nucleus (STN) on the local cerebral glucose metabolism in patients with advanced Parkinson’s disease (PD) and to explore the mechanism of DBS. Methods Seven patients with advanced PD with bilateral STNDBS underwent 18F-FDG / PET and UPDRS scores respectively before and one month after operation under the stimulation of SPM99 statistical software Data analysis was performed to investigate the effect of bilateral STNDBS on brain metabolism in PD patients. Results Both sides of STNDBS markedly improved the clinical symptoms of PD patients, and at the same time, there was a significant change in brain glucose metabolism: bilateral lentiform nucleus, brainstem (midbrain, pons), bilateral occipital part, pre-exercise area (BA6) And cingulate gyrus increased metabolism; brain metabolism at the bottom of the prefrontal cortex and hippocampus decreased (P <0.05). Conclusions Bilateral STNDBS may improve the metabolism of up and down basal ganglia in the axon projection area and increase the metabolism of the corresponding frontal high center of motion, which may improve the clinical symptoms of PD patients.