Журнал неврологии и нейрохирургических исследований / Journal of Neurology and Neurosurgical Research 7-jild 5-son (2026)
BILATERAL THALAMIC DEEP BRAIN STIMULATION IN ADVANCED TREMOR-RIGID PARKINSON DISEASE: A CASE REPORT WITH MULTIMODAL CLINICAL AND STEREOTACTIC ASSESSMENT
Алиев Мансур Абдухоликович, Саит ОЗТЮРК
Annotatsiya
Background. Deep brain stimulation (DBS) is an established functional neurosurgical treatment for selected patients with Parkinson disease (PD) who develop disabling tremor, motor fluctuations, or insufficient symptom control despite optimized pharmacotherapy. We report a woman born in 1968 with PD diagnosed after symptom onset in 2016. Her phenotype was characterized by prominent resting and mixed tremor, hypokinesia, muscular rigidity, hypomimia, plastic hypertonia, freezing of gait, postural instability, propulsion, retropulsion, lateropulsion, recurrent falls, and progressive impairment of independent ambulation. The disease was classified as Hoehn–Yahr stage IV, with a Karnofsky Performance Status of 70. Case Report. Despite intensive multidrug antiparkinsonian treatment, motor disability progressed. On August 28, 2025, the patient underwent bilateral DBS implantation targeting the posterior ventrolateral thalamic region as defined in the operative stereotactic protocol. A Zamorano–Duchovny frame was used with stereotactic MSCT acquisition, DICOM transfer to the navigation workstation, and Medtronic DBS planning software. Bilateral electrodes were implanted through 14-mm frontal-parietal burr holes and verified intraoperatively using C-arm fluoroscopy. The leads were connected to a pulse generator implanted in the right upper chest. Longitudinal outcome assessment was structured using MDS-UPDRS, Hoehn–Yahr staging, PDQ-39, MoCA, Berg Balance Scale, Timed Up and Go, Schwab and England ADL, and dopaminergic medication burden. Conclusion. Bilateral thalamic DBS provided a rational neuromodulatory strategy for prominent medically refractory tremor in advanced PD. Multimodal assessment is essential for differentiating tremor suppression from changes in rigidity, bradykinesia, gait, balance, functional independence, and quality of life.
болезнь Паркинсона, DBS, глубокая стимуляция мозга, таламус, вентролатеральное ядро, тремор, ригидность, стереотаксия, MDS-UPDRS, нейромодуляцияParkinson disease, deep brain stimulation, DBS, thalamus, ventrolateral thalamus, tremor, rigidity, stereotactic neurosurgery, MDS-UPDRS, neuromodulationParkinson kasalligi, DBS, miyaning chuqur stimulyatsiyasi, talamus, ventrolateral yadro, tremor, rigidlik, stereotaksiya, MDS-UPDRS, neyromodulyatsiya
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