De Gaspari D, Siri C, Di Gioia M, Antonini A, Isella V, Pizzolato A, Landi A, Vergani F, Gaini S M, Appollonio I M, Pezzoli G
Department of Neuroscience, Center for Parkinson's Disease, Istituti Clinici di Perfezionamento, Milan, Italy.
Parkinsonism Relat Disord. 2006 Jun;12(5):289-95. doi: 10.1016/j.parkreldis.2006.01.001. Epub 2006 Mar 22.
A decline in verbal fluency is the most consistent neuropsychological sequela of deep brain stimulation (DBS) for Parkinson's disease. We assessed clinical correlates and switching and clustering subcomponents in 26 parkinsonians undergoing subthalamic DBS. Post-surgical motor improvement was accompanied by worsening at both letter and category fluency tasks. Total number of words and switches decreased, while average cluster size was unchanged. Worsening tended to be prominent in patients with baseline poorer cognitive status and more depressed mood. Impairment of shifting suggests prefrontal dysfunction, possibly due to disruption of fronto-striatal circuits along the surgical trajectory and/or to high frequency stimulation itself.
言语流畅性下降是帕金森病深部脑刺激（DBS）最常见的神经心理学后遗症。我们评估了26例接受丘脑底核DBS的帕金森病患者的临床相关性以及转换和聚类子成分。术后运动功能改善的同时，字母流畅性任务和类别流畅性任务均出现恶化。单词总数和转换次数减少，而平均聚类大小不变。认知状态较差和情绪较抑郁的患者恶化往往更为明显。转换功能受损提示前额叶功能障碍，可能是由于手术路径沿线的额纹状体回路中断和/或高频刺激本身所致。
