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Methods for programming and patient management with deep brain stimulation of the globus pallidus for the treatment of advanced Parkinson's disease and dystonia.

机译:用苍白球深部脑刺激治疗晚期帕金森氏病和肌张力障碍的程序和患者管理方法。

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摘要

Globus pallidus (GPi) deep brain stimulation can markedly improve severe medication-refractory Parkinson's disease (PD) and dystonia. Appropriate perioperative patient management can assist with electrode implantation. Optimizing stimulation settings and simultaneously adjusting medications (when appropriate) can substantially improve patient outcomes. Although there are a large number of possible stimulation settings, in clinical practice, a relatively narrow range of settings has been shown to be most efficacious. A systematic approach to determining those settings that maximally improve parkinsonism and suppress drug-induced dyskinesias is outlined following a clear algorithm that uses the observation that stimulation of the dorsal and ventral pallidum has been shown to have opposite motor effects in PD. Based on the available literature, recommendations are also made for the use of GPi deep brain stimulation in dystonia.
机译:苍白球(GPi)深度大脑刺激可以显着改善重度药物难治性帕金森氏病(PD)和肌张力障碍。适当的围手术期患者管理可以协助电极植入。优化刺激设置并同时调整药物治疗(适当时)可以大大改善患者的治疗效果。尽管存在大量可能的刺激设置,但是在临床实践中,已显示相对狭窄的设置范围是最有效的。在一个清晰的算法之后,概述了一种系统的方法来确定那些设置,这些设置可以最大程度地改善帕金森氏症和抑制药物诱发的运动障碍,该算法使用了观察到的对背部和腹侧苍白球的刺激在PD中具有相反的运动效应的观察。根据现有文献,还提出了在肌张力障碍中使用GPi深层脑刺激的建议。

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