可充电可远程程控3.0T 核磁兼容脑深部电刺激系统治疗1例帕金森病的随访1年临床效果及影像学分析

doi:10.19854/j.cnki.1008-2425.2023.06.0001

立体定向和功能性神经外科杂志 ›› 2023, Vol. 36 ›› Issue (6): 321-326.DOI: 10.19854/j.cnki.1008-2425.2023.06.0001

• 论著 • 下一篇

可充电可远程程控3.0T 核磁兼容脑深部电刺激系统治疗1例帕金森病的随访1年临床效果及影像学分析

牛朝诗, 陈鹏, 熊赤

230001 合肥中国科学技术大学附属第一医院(安徽省立医院)神经外科(牛朝诗,陈鹏,熊赤);脑功能与脑疾病安徽省重点实验室(牛朝诗,陈鹏),安徽省脑立体定向神经外科研究所(牛朝诗,熊赤)

收稿日期:2023-12-06 出版日期:2023-12-25 发布日期:2024-01-18
通讯作者: 牛朝诗 niuchaoshi@ustc.edu.cn
基金资助:
安徽省医疗卫生重点专科建设项目[皖卫函(2021)273号],安徽省高校优秀科研创新团队项目(编号:2023AH010080)

Rechargeable and remote programmable 3.0T magnetic resonance compatible deep brain stimulation system for the treatment of Parkinson's disease:a one-year follow-up clinical effect and imaging analysis

Niu Chaoshi, Chen peng, Xiong Chi

1. Department of Neurosurgery,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui,230036,China;
2. Anhui Key Laboratory of Brain Function and Diseases,Hefei,Anhui,230036,China;
3. Anhui Provincial Stereotactic Neurosurgical Institute,Hefei,Anhui,230001,China

Received:2023-12-06 Online:2023-12-25 Published:2024-01-18

摘要/Abstract

摘要： 目的探讨可充电可远程程控3.0T核磁兼容脑深部刺激系统在帕金森病丘脑底核刺激术后的治疗效果、影像学成像及治疗机制中的应用。方法分析2022年10月10日在中国科学技术大学附属第一医院(安徽省立医院)神经外科开展的全球首例可充电可远程3.0T核磁兼容脑深部刺激系统治疗帕金森患者1例,对随访1年的临床资料进行分析。术后1周及1年分别行3.0T颅脑核磁检查,评估临床症状、磁共振成像和神经刺激器电极阻抗的稳定性。结果术后4周开机至术后随访1年,患者运动(UPDRS-III、UPDRS-IV改善率分别为95.31%、75.00%)及非运动症状(NMSS、PDSS、PDQ39、MoCA、HAMA、HAMD、CCS改善率分别为85.42%、24.53%、91.23%、7.14%、84.61%、100.00%、57.14%)明显改善,药量减少(LED减少34.61%),且刺激参数稳定。3.0T核磁影像学检查(T1、T2、3DT1、DTI、rs-fMRI)成像正常,结构像可清晰显示电极及核团位置,功能磁共振成像提示开机状态下脑局部神经元活动增加,脑功能连接增强。检查过程神经脉刺激器电极阻抗稳定,无不良事件发生。结论 3.0T核磁兼容脑深部刺激设备应用于帕金森病患者的手术治疗效果确切,同时提升了术后影像评估准确性,对于探讨脑深部刺激治疗帕金森病的影像学机制具有重要价值。

关键词: 远程程控, 可充电, 3.0T核磁共振, 功能成像, 临床效果, 脑深部电刺激

Abstract: Objective Exploring the therapeutic effects,imaging,and therapeutic mechanisms of a rechargeable and remotely programmable 3.0T MRI compatible deep brain stimulation system in patients with Parkinson's disease after subthalamic nucleus stimulation surgery.Methods Analyze the clinical data of one Parkinson's patient treated with the world's first rechargeable and remote 3.0T MRI compatible deep brain stimulation system at the Neurosurgery Department of the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital) on October 10,2022.Follow up data for one year will be analyzed.3.0T cranial magnetic resonance imaging was performed 1 week and 1 year postoperatively to evaluate clinical symptoms,magnetic resonance imaging,and stability of electrode impedance.Results From 4 weeks after surgery to 1 year of follow-up,the improvement rates of exercise (UPDRS-III and UPDRS-IV were 95.31% and 75.00%,respectively) and non exercise symptoms (NMSS,PDSS,PDQ39,MoCA,HAMA,HAMD,CCS improvement rates were 85.42%,24.53%,91.23%,7.14%,84.61%,100.00%,57.14%,respectively) were significantly improved,and the dosage of medication was reduced (LED decreased by 34.61%),with stable stimulation parameters.3.0T magnetic resonance imaging examination (T1,T2,3DT1,DTI,rs fMRI) showed normal imaging,and the structural image could clearly display the position of electrodes and nuclei.Functional magnetic resonance imaging indicated increased local neuronal activity and enhanced brain functional connectivity in the turned on state.The electrode impedance during the inspection process is stable and no adverse events have occurred.Conclusion The application of 3.0T MRI compatible deep brain stimulation equipment in the surgical treatment of Parkinson's disease patients has a definite effect,while improving the accuracy of postoperative imaging evaluation.It is of great value for exploring the imaging mechanism of deep brain stimulation treatment for Parkinson's disease.

Key words: Remote control program, Rechargeable, 3.0T magnetic resonance imaging, Functional imaging, Clinical effects, Deep brain stimulation

中图分类号:

R742.5

牛朝诗, 陈鹏, 熊赤. 可充电可远程程控3.0T 核磁兼容脑深部电刺激系统治疗1例帕金森病的随访1年临床效果及影像学分析[J]. 立体定向和功能性神经外科杂志, 2023, 36(6): 321-326.

Niu Chaoshi, Chen peng, Xiong Chi. Rechargeable and remote programmable 3.0T magnetic resonance compatible deep brain stimulation system for the treatment of Parkinson's disease:a one-year follow-up clinical effect and imaging analysis[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2023, 36(6): 321-326.

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可充电可远程程控3.0T 核磁兼容脑深部电刺激系统治疗1例帕金森病的随访1年临床效果及影像学分析

Rechargeable and remote programmable 3.0T magnetic resonance compatible deep brain stimulation system for the treatment of Parkinson's disease:a one-year follow-up clinical effect and imaging analysis

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