Adaptive deep brain stimulation targeting the subthalamic nucleus in a patient with Parkinson's disease: A CARE compliant case report

针对帕金森病患者丘脑底核的适应性深部脑刺激:符合CARE指南的病例报告

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Abstract

RATIONALE: Adaptive deep brain stimulation (aDBS) represents a notable advancement in treating Parkinson's disease (PD), as it offers enhanced therapeutic outcomes and personalized management by adjusting stimulation parameters in real-time according to individual neural signals. This approach minimizes adverse effects commonly associated with standard continuous deep brain stimulation (cDBS). This case report describes the progress of a 62-year-old man with severe PD who demonstrated notable enhancement in motor symptoms and quality of life throughout a 3-month trial period using aDBS. PATIENT CONCERNS: A 62-year-old man who has been suffering from Parkinson's disease. DIAGNOSES: The patient had been diagnosed with PD for 10 years. The patient's motor symptoms, including dyskinesia during the on-state and akinesia during the off-state, progressively worsened over time. INTERVENTIONS: The patient underwent bilateral subthalamic nuclei DBS surgery with cDBS. Following progressive worsening of motor symptoms, he was transitioned to aDBS. OUTCOMES: The aDBS system adaptively modified stimulation parameters by utilizing real-time neural feedback from beta band activity detected in the subthalamic nucleus, resulting in decreased dyskinesia and reduced reliance on medication. The customized strategy led to a significant improvement in motor symptoms, a reduction in dyskinesia, and an overall enhancement in quality of life during the 3-month trial period. LESSONS: Existing evidence highlights the ability of aDBS to improve motor control and reduce problems associated with DBS, such as speech and gait abnormalities. Research findings have demonstrated significant improvements in motor scores and a reduction in stimulation time, highlighting the effectiveness of aDBS and its ability to prolong the lifespan of devices.

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