Piasecki Shelley D, Jefferson James W
University of Wisconsin Psychiatric Institute and Clinics, Madison.
J Clin Psychiatry. 2004 Jun;65(6):845-9. doi: 10.4088/jcp.v65n0617.
The purpose of this article is to review the current literature regarding deep brain stimulation (DBS) of the subthalamic nucleus as a treatment for Parkinson's disease and to bring to the attention of the psychiatric community the possible psychiatric complications of this treatment.
A MEDLINE search of English-language publications was conducted using PubMed in July 2003. The search term used was deep brain stimulation. In addition, pertinent references were obtained from the retrieved articles. Reports and studies of psychiatric complications of DBS patients were reviewed and are discussed. A case report is presented of a man who developed hypomanic symptoms shortly after beginning DBS treatment for Parkinson's disease.
There have been an increasing number of reports of postprocedure psychiatric complications, including depression, mania, aggression, and deficits in language. Improvement in symptoms of severe obsessive-compulsive disorder and depression has also been reported.
As information continues to emerge, psychiatrists will play vital roles in the assessment and continuing care of patients who receive DBS. These findings may also provide the framework to determine which patients are at psychiatric risk from DBS. Symptoms of refractory obsessive-compulsive disorder have been noted to improve with DBS, which has led researchers to begin studying its effectiveness for this condition.
本文旨在回顾目前有关丘脑底核深部脑刺激（DBS）治疗帕金森病的文献，并提请精神医学界关注该治疗可能出现的精神并发症。
2003年7月使用PubMed对英文出版物进行了MEDLINE检索。使用的检索词为“深部脑刺激”。此外，从检索到的文章中获取了相关参考文献。对DBS患者精神并发症的报告和研究进行了综述并加以讨论。本文报告了1例在开始DBS治疗帕金森病后不久出现轻躁狂症状的男性病例。
术后精神并发症的报告越来越多，包括抑郁、躁狂、攻击行为和语言缺陷。也有报告称严重强迫症和抑郁症的症状有所改善。
随着信息不断涌现，精神科医生在接受DBS治疗患者的评估和持续护理中将发挥至关重要的作用。这些发现也可能为确定哪些患者有DBS引发精神问题的风险提供框架。难治性强迫症的症状已被注意到通过DBS得到改善，这促使研究人员开始研究其对这种疾病的有效性。
