Smeding H M M, Speelman J D, Koning-Haanstra M, Schuurman P R, Nijssen P, van Laar T, Schmand B
Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands.
Neurology. 2006 Jun 27;66(12):1830-6. doi: 10.1212/01.wnl.0000234881.77830.66.
To evaluate the cognitive and behavioral effects of bilateral subthalamic nucleus (STN) stimulation in patients with Parkinson disease (PD).
The authors included 103 patients; 99 patients were evaluated 6 months after surgery. A control group of 39 patients with PD was formed and 36 patients were evaluated 6 months later. At baseline and at follow-up we administered neuropsychological tests of language, memory, visuospatial function, mental speed, and executive functions. A depression rating scale, a quality of life scale, self and proxy ratings of memory and dysexecutive symptoms, and a neuropsychiatric interview were also administered.
Six months after surgery, the STN group showed a larger decline than the control group on measures of verbal fluency, color naming, selective attention, and verbal memory. Moreover, the STN group showed a decrease in positive affect, and an increase in emotional lability and cognitive complaints. On the other hand, the STN group showed an increase in quality of life and a slight decrease in depressive symptoms. Nine percent of the STN patients had psychiatric complications (vs 3% of controls).
Bilateral subthalamic nucleus stimulation has an adverse effect on executive functions with implications for daily life of the patients and their relatives.
评估双侧丘脑底核（STN）刺激对帕金森病（PD）患者认知和行为的影响。
作者纳入了103例患者；99例患者在术后6个月接受评估。组建了一个由39例PD患者组成的对照组，36例患者在6个月后接受评估。在基线和随访时，我们进行了语言、记忆、视觉空间功能、心理速度和执行功能的神经心理学测试。还进行了抑郁评定量表、生活质量量表、记忆和执行功能障碍症状的自我及代理评定，以及神经精神访谈。
术后6个月，STN组在言语流畅性、颜色命名、选择性注意力和言语记忆测量方面的下降幅度大于对照组。此外，STN组积极情绪减少，情绪不稳定和认知抱怨增加。另一方面，STN组生活质量提高，抑郁症状略有减轻。9%的STN患者有精神并发症（对照组为3%）。
双侧丘脑底核刺激对执行功能有不利影响，对患者及其亲属的日常生活产生影响。
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