Neurological Surgery 脳神経外科47巻1号

2019年01月発行

特別寄稿 脳神経外科コントロバーシー2019

（2）パーキンソン病に対するDBS—STN vs. GPi

著者： 平林秀裕¹ 永田清¹ 下川原立雄¹ 佐々木亮太¹ 村瀬永子²

所属機関： ¹独立行政法人国立病院機構奈良医療センター脳神経外科 ²独立行政法人国立病院機構奈良医療センター不随意運動疾患センター

ページ範囲：P.15 - P.26

Ⅰ．はじめに
　パーキンソン病に対する脳深部刺激療法（deep brain stimulation therapy：DBS）は，薬物療法で改善が不十分なパーキンソン病の運動合併症の治療手段として確立されている³⁵⁾．
　DBSには，視床刺激術，視床下核刺激術（STN-DBS），淡蒼球刺激術（GPi-DBS）があるが，視床刺激術は専ら振戦の治療に用いられ，パーキンソン病の運動合併諸症状の改善には，STN-DBSまたはGPi-DBSが適応される．STN-DBSはBenabidら⁵⁾により，GPi-DBSはSiegfriedらにより⁴⁹⁾開発された手術方法で，両者はいずれも運動合併諸症状を改善するが，その優劣についてはいまだに議論があり，症例ごとにいずれの手術を適応するか検討する必要がある．

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