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Effect of thalamic deep brain stimulation on swallowing in patients with essential tremor.

丘脑深部脑刺激对特发性震颤患者吞咽功能的影响

  • 影响因子:4.6560
  • DOI:10.1002/acn3.51099
  • 作者列表:"Lapa S","Claus I","Reitz SC","Quick-Weller J","Sauer S","Colbow S","Nasari C","Dziewas R","Kang JS","Baudrexel S","Warnecke T
  • 发表时间:2020-06-16
Abstract

OBJECTIVE:Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) is a mainstay treatment for severe and drug-refractory essential tremor (ET). Although stimulation-induced dysarthria has been extensively described, possible impairment of swallowing has not been systematically investigated yet. METHODS:Twelve patients with ET and bilateral VIM-DBS with self-reported dysphagia after VIM-DBS were included. Swallowing function was assessed clinically and using by flexible endoscopic evaluation of swallowing in the stim-ON and in the stim-OFF condition. Presence, severity, and improvement of dysphagia were recorded. RESULTS:During stim-ON, the presence of dysphagia could be objectified in all patients, 42% showing mild, 42% moderate, and 16 % severe dysphagia. During stim-OFF, all patients experienced a statistically significant improvement of swallowing function. INTERPRETATION:VIM-DBS may have an impact on swallowing physiology in ET-patients. Further studies to elucidate the prevalence and underlying pathophysiological mechanisms are warranted.

摘要

目的: 腹侧中间核 (VIM) 深部脑刺激 (DBS) 是治疗严重和药物难治性特发性震颤 (ET) 的主要方法。虽然刺激诱导的构音障碍已被广泛描述,但吞咽可能的障碍尚未被系统研究。 方法: 纳入 12 例 VIM-DBS 术后自行报告吞咽困难的 ET 和双侧 VIM-DBS 患者。通过灵活的内镜评估 stim-ON 和 stim-OFF 条件下的吞咽功能进行临床和使用评估。记录吞咽困难的存在、严重程度和改善情况。 结果: 在 stim-ON 期间,所有患者均可客观化吞咽困难的存在,42% 显示轻度、 42% 中度和 16% 重度吞咽困难。在 stim-OFF 期间,所有患者吞咽功能均有统计学显著改善。 解读: VIM-DBS 可能对 ET 患者的吞咽生理有影响。需要进一步的研究来阐明患病率和潜在的病理生理机制。

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