Table_1_Bilateral Globus Pallidus Interna Combined With Subthalamic Nucleus Variable Frequency Deep Brain Stimulation in the Treatment of Young-Onset Parkinson's Disease With Refractory Dyskinesia: A Case Report.DOCX

Background: Main motor characteristics in Parkinson's disease (PD) include bradykinesia, rigidity, and tremors. With the development of neuromodulation techniques, it has become possible to use deep brain stimulation (DBS) to control the symptoms of PD. However, since the subthalamic nucleus(STN) and globus pallidus interna (GPi) DBS have their own advantages and disadvantages, it is difficult to control symptoms of the patients. It is essential to find new stimulation methods.Case Presentation: A 33-year-old male PD patient with onset at the age of 12 years. The onset of the disease is presented with bradykinesia and progressively developed severe choreic dyskinesia with the use of medications. We then performed a thorough evaluation of the patient and decided to perform bilateral globus pallidus interna combined with subthalamic nucleus variable frequency DBS (bSGC-DBS) implantation, and after 2 years of follow-up the patient's bradykinesia and dyskinesia symptoms and quality of life improved significantly.Conclusions: This is the first case of bSCG-DBS in a PD patient with refractory dyskinesia, and the first report of encouraging results from this clinical condition. This important finding explores multi-electrode and multi-target stimulation for the treatment of dystonia disorders.

背景：帕金森病（PD）的主要运动特征包括运动迟缓、僵硬和震颤。随着神经调节技术的进步，深部脑刺激（DBS）已可用于控制PD的症状。然而，由于丘脑底核（STN）和苍白球内侧（GPi）的DBS各自具有其优势和劣势，控制患者症状变得困难。寻找新的刺激方法显得尤为关键。病例报告：一位33岁男性PD患者，12岁时发病。疾病初期表现为运动迟缓，并在用药后逐渐发展为严重的舞蹈样运动障碍。随后我们对患者进行了全面评估，并决定进行双侧苍白球内侧与丘脑底核可变频率DBS（bSGC-DBS）植入术，经过2年的随访，患者的运动迟缓、舞蹈样运动障碍症状和生活质量显著改善。结论：这是首个在具有难治性舞蹈样运动障碍的PD患者中实施bSCG-DBS的案例，也是首次报告该临床条件令人鼓舞的结果。这一重要发现探索了多电极和多靶点刺激在治疗肌张力障碍疾病中的应用。