Neurological Surgery 脳神経外科39巻1号

2011年01月発行

解剖を中心とした脳神経手術手技

パーキンソン病に対する脳深部刺激療法の目標点決定法

著者： 戸田弘紀¹

所属機関： ¹田附興風会医学研究所北野病院脳神経外科

ページ範囲：P.25 - P.35

Ⅰ．はじめに

　脳深部刺激療法（deep brain stimulation，DBS）はパーキンソン病および本態性振戦に対する外科的治療法としてわが国では2000年に保険認可され現在まで広く普及している．進行期パーキンソン病にみられる日内変動やジスキネジアに対してDBSは有効で⁶⁾，最近の無作為化比較試験^8,38)ではDBS・薬物療法併用群が薬物療法単独群に比べてよりよい結果を示した．DBSの効果を十分に引き出すためには，安全で正確な手術を行うことが重要である．本稿ではパーキンソン病に対するDBSについて，治療適応，刺激部位選択，手術手順と目標点座標決定法を解説する．

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