脑深部电刺激术的电极移位

目的研究脑深部电刺激术(DBS)电极移位的原因及预防措施.方法研究113例帕金森病DBS术中及术后程控时的深部电极与预置靶点的差异.结果发生电极移位5例,其中术中发生2例;3例术中刺激效果满意,电极未发生移位,但术后4周程控时达不到满意效果,复查头颅MRI示脑深部电极移位,2例比原定位置深4 mm,1例比原定位置深6 mm.结论植入的刺激电极在颅内移位是影响DBS治疗效果的重要因素,可造成某些病人术中刺激效果好,但一段时间后疗效差的现象,应积极预防.

Dislocation of electrode during or after deep brain stimulation

Objective To evaluate the phenomenon of dislocations of the placed electrode in patients with advanced Parkinson disease undergoing deep brain stimulation. Methods The electrode positions were compared with the preoperative planned targets by MRI or X ray. Results Dislocation of electrode was found in 5 cases, it happened during operation in 2 cases, 3 cases had good external stimulation effects and the dislocation of the placed electrode compared with its planed target point was ruled out by intraoperative image, but MRI showed dislocation of electrode in 4 weeks after the operation, 2 cases of them showed 4mm deeper than preoperative planned targets, and 1 case showed 6mm deeper. Conclusions The dislocation of electrode was an important factor that made the chronic stimulation effect worse in some patients who had had good external intraoperative stimulation effects, and should be actively prevented. Postoperative MR image could verify the dislocation of electrode and help processing.