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双靶点脑深部电刺激术治疗难治性强迫症的临床研究(附4例报告)

Clinical Study of Dual-target Deep Brain Stimulation in the Treatment of Refractory Obsessive-Compulsive Disorder(Report of 4 Cases)
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摘要 目的探讨内囊前肢-伏隔核双靶点脑深部电刺激治疗难治性强迫症的疗效及安全性。方法对湖南省第二人民医院2021年12月~2022年5月采用以内囊前肢-伏隔核为双靶点的脑深部电刺激治疗的4名难治性强迫症患者进行随访研究,术前、术后6个月及1年应用耶鲁-布朗强迫量表(Y-BOCS)、汉密顿焦虑量表(HAMA)评价。结果术后6个月、1年的Y-BOCS量表、HAMA量表、强迫思维、强迫行为评分比术前有明显下降(P<0.05)。结论4名难治性强迫症患者经以内囊前肢-伏隔核双靶点的脑深部电刺激治疗后强迫症症状和焦虑得到明显改善,初步显示该技术治疗难治性强迫症的有效和安全性。 Objective To explore the efficacy and safety of deep brainstimulation with dual targets of the anterior limb of the internal capsule and the nucleus accumbens in the treatment of refractory obsessive-compulsive disorder.Methods A follow-up study was conducted on 4 patients with refractory obsessive-compulsive disorder who received deep brain stimulation with the anterior limb of the internal capsule and the nucleus accumbens as dual targets at The Second People's Hospital of Hunan Province from December 2021 to May 2022.The patients were evaluated using the Yale-Brown Obsessive-Compulsive Scale(Y-BOCS)and the Hamilton Anxiety Rating Scale(HAMA)before surgery,6 months,and 1 year after surgery.Results The scores of the Y-BOCS scale,HAMA scale,obsessive thoughts,and obsessive behaviors at 6 months and 1 year after surgery were significantly reduced compared with those before surgery(P<0.05).Conclusion The obsessive-compulsive symptoms and anxiety of the four patients with refractory obsessive-compulsive disorder were significantly improved after deep brain stimulation with dual targets of the anterior limb of the internal capsule and the nucleus accumbens,which preliminarily showed the effectiveness and safety of this technology in the treatment of refractory obsessive-compulsive disorder.
作者 吴欣雨 杨萍 匡卫平 黄红星 李波 黄亚辉 Wu Xinyu;Yang Ping;Kuang Weiping;Huang Hongxing;Li Bo(Clinical Medicine College of Hunan University of Chinese Medicine,Changsha,410208,China;Department of Psychiatry,The Second People's Hospital of Hunan Province,Changsha,Hunan 410007,China;Department of Neurosurgery,The Second People's Hospital of Hunan Province,Changsha,Hunan,410007,China)
出处 《立体定向和功能性神经外科杂志》 2025年第5期272-277,共6页 Chinese Journal of Stereotactic and Functional Neurosurgery
基金 湖南省自然科学基金项目(编号:2023JJ60292,2023JJ30339) 湖南省重点研发计划项目(编号:2022SK2163) 湖南省临床医学研究中心(编号:2021SK4022,2023SK4020) 湖南省卫生健康委科研课题(编号:202204042927)。
关键词 脑深部电刺激 难治性强迫症 内囊前肢 伏隔核 Deep brain stimulation Refractory obsessive-compulsive disorder Anterior limb of internal capsule Nucleus accumbens
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