Zibetti M, Torre E, Cinquepalmi A, Rosso M, Ducati A, Bergamasco B, Lanotte M, Lopiano L
Department of Neuroscience, University of Turin, Turin, Italy.
Eur Neurol. 2007;58(4):218-23. doi: 10.1159/000107943. Epub 2007 Sep 7.
To evaluate motor and nonmotor symptoms in patients with Parkinson's disease undergoing bilateral deep brain stimulation of the subthalamic nucleus (STN DBS).
Thirty-six consecutive patients receiving bilateral STN stimulation implants were evaluated preoperatively as well as 12 and 24 months after surgery. Motor symptoms were assessed through the Unified Parkinson's Disease Rating Scale (UPDRS). Data concerning nonmotor symptoms were collected from items of the UPDRS and 2 additional questions from clinical charts regarding constipation and urological dysfunction.
STN DBS was effective in controlling motor symptoms; concerning nonmotor symptoms, sleep quality and constipation improved after surgery as compared to baseline. Salivation, swallowing and sensory complaints were ameliorated to a comparable degree by the medication on state, whether preoperatively or postoperatively. With a lower dose of dopaminergic medication, however, the medication on state appeared to be a much larger percentage of the day postoperatively. No significant variations were detected in intellectual impairment, depression, thought disorders, motivation, falling unrelated to freezing, nausea, orthostatic hypotension and urological dysfunction.
STN DBS effectively controls motor symptoms, while nonmotor features of advanced Parkinson's disease patients are mostly unchanged after surgery, even though some specific aspects, notably sleep complaints and constipation, are ameliorated.
评估接受双侧丘脑底核脑深部电刺激（STN DBS）的帕金森病患者的运动和非运动症状。
对36例连续接受双侧STN刺激植入的患者在术前以及术后12个月和24个月进行评估。通过统一帕金森病评定量表（UPDRS）评估运动症状。从UPDRS项目以及临床病历中关于便秘和泌尿功能障碍的另外两个问题收集有关非运动症状的数据。
STN DBS有效控制运动症状；关于非运动症状，与基线相比，术后睡眠质量和便秘有所改善。术前或术后，通过状态用药，流涎、吞咽和感觉障碍均有类似程度的改善。然而，使用较低剂量的多巴胺能药物时，术后状态用药在一天中所占比例似乎大得多。在智力损害、抑郁、思维障碍、动机、与冻结无关的跌倒、恶心、直立性低血压和泌尿功能障碍方面未检测到显著变化。
STN DBS有效控制运动症状，晚期帕金森病患者的非运动特征在术后大多未改变，尽管某些特定方面，尤其是睡眠障碍和便秘有所改善。
