McNeely Heather E, Mayberg Helen S, Lozano Andres M, Kennedy Sidney H
Schizophrenia Services, Neuropsychology Service, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
J Nerv Ment Dis. 2008 May;196(5):405-10. doi: 10.1097/NMD.0b013e3181710927.
The purpose of this study was to evaluate preservation of cognitive function after deep brain stimulation (DBS) of the subgenual cingulate (Cg25) for treatment-resistant depression (TRD). We have previously reported on the treatment methods, safety, and 6-month clinical outcome (Mayberg et al., Neuron. 2005;45:651-660). Comprehensive neuropsychological assessments tapping 4 domains of frontal lobe function, and general cognitive abilities, were completed before implantation and at 3, 6, and 12 months postonset of continuous DBS in 6 TRD patients. No adverse neuropsychological effects were noted following surgery, onset and maintenance of DBS with the exception of transient motor slowing noted at 3 and 6 months that improved to normative levels by 12 months. Several areas of cognition that were below average or impaired at baseline improved over follow-up, and these changes were not correlated with improvements in mood. Though the sample size is small, these results support cognitive safety of Cg25 DBS for TRD.
本研究的目的是评估针对难治性抑郁症(TRD)进行扣带回下区(Cg25)深部脑刺激(DBS)后认知功能的保留情况。我们之前已经报道过治疗方法、安全性以及6个月的临床结果(Mayberg等人,《神经元》。2005年;45:651 - 660)。在6例TRD患者植入前以及持续DBS开始后3、6和12个月,完成了涵盖额叶功能4个领域以及一般认知能力的综合神经心理学评估。除了在3个月和6个月时出现短暂的运动迟缓,到12个月时恢复到正常水平外,手术、DBS启动及维持后未发现不良神经心理学效应。几个在基线时低于平均水平或受损的认知领域在随访过程中有所改善,且这些变化与情绪改善无关。尽管样本量较小,但这些结果支持Cg25 DBS治疗TRD的认知安全性。