CAJ | 학술논문

目的分析帕金森病(PD)患者丘脑底核(STN)脑深部刺激术(DBS)治疗前后脑多巴胺转运体(DAT)浓度变化及其与疗效的关系,探讨DBS治疗机制.方法 2011年2月至2011年7月,13例接受STN-DBS治疗的PD患者分别在术前1周和术后6个月行脑部11C-β-CFT-PET/CT扫描.结果 PD患者纹状体各感兴趣区(ROI)DAT浓度明显降低(P＜0.05),并且术后进一步下降.术前尾状核、前壳核及后壳核DAT浓度与术前药物“开”期UPDRSⅢ评分呈明显负相关(R2分别为0.522、0.380、0.419).术后尾状核、前壳核及后壳核DAT浓度与术后电刺激“开”期UPDRSⅢ评分呈明显负相关(R2分别为0.402、0.350、0.307).结论 STN-DBS对多巴胺神经元转运体没有明显保护作用,但DAT浓度测定可能成为预测各种抗PD治疗效果的一个客观指标.
목적 분석파금삼병(PD)환자구뇌저핵(STN)뇌심부자격술(DBS)치료전후뇌다파알전운체(DAT)농도변화급기여료효적관계,탐토DBS치료궤제.방법 2011년2월지2011년7월,13례접수STN-DBS치료적PD환자분별재술전1주화술후6개월행뇌부11C-β-CFT-PET/CT소묘.결과 PD환자문상체각감흥취구(ROI)DAT농도명현강저(P＜0.05),병차술후진일보하강.술전미상핵、전각핵급후각핵DAT농도여술전약물“개”기UPDRSⅢ평분정명현부상관(R2분별위0.522、0.380、0.419).술후미상핵、전각핵급후각핵DAT농도여술후전자격“개”기UPDRSⅢ평분정명현부상관(R2분별위0.402、0.350、0.307).결론 STN-DBS대다파알신경원전운체몰유명현보호작용,단DAT농도측정가능성위예측각충항PD치료효과적일개객관지표.
Objective To determine the relationship between the change of dopamine transporter (DAT) and clinical efficacy of the subthalamic nucleus deep brain stimulation (STN-DBS)for Parkinson's Disease (PD) patients.Methods Between February 2011 and July 2011,13 PD patients received 11 C-β-CFT-PET/CT brain scan in a week before and 6 months after the STN-DBS treatment.Results The DAT in corpus striatum significantly decreased in all the patients and significantly decreased after surgery (P ＜ 0.05).The preoperative UPDRS Ⅲ score with medication 'on 'was significant negative correlation with the preoperative DAT level in caudatum and putamen.The R2 were 0.522,0.380,0.419 respectively.The negative correlation was also found between postoperative UPDRS Ⅲ score with the postoperative DAT level when simulation was 'on'.The R2were 0.402,0.350,0.307 respectively.The most correlated factor was the DAT level in caudatum by mult-variable linear return analysis.Conclusions It was not found that the dopamine neuron was protected by STN-DBS.DAT level may be an objective indicator to estimate the efficacy of anti-parkinsonian therapy.