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帕金森病中丘脑底核的深部脑刺激与认知功能

Deep brain stimulation of the subthalamic nucleus and cognitive functions in Parkinson's disease.

作者信息

Klempírová O, Jech R, Urgosík D, Klempír J, Spacková N, Roth J, Růzicka E

机构信息

Charles University in Prague, First Faculty of Medicine and General Teaching Hospital, Czech Republic.

出版信息

Prague Med Rep. 2007;108(4):315-23.

Abstract

Deep brain stimulation of the subthalamic nucleus (DBS/STN) is an effective treatment for motor symptoms in advanced Parkinson's disease (PD). However, it is less clear how DBS/STN affects cognitive functions. We investigated 19 PD patients (13 male, 6 female, mean age 57 +/- 6, mean PD duration 15 +/- 4 years) who received bilateral DBS/STN. Neuropsychological assessment was done before the surgery and at least 12 months after DBS implantation. The patients were examined in their optimal motor status. Global cognitive performance measured by Mattis Dementia Rating Scale was not significantly changed after DBS STN. The performance in Wechsler Memory Scale III decreased in the subtest Logical Memory, in delayed recall (p < 0.05) and in recognition (p < 0.05). In Stroop Test, the performance worsened in the second (p < 0.05), and third condition (p < 0.01) measuring interference and ability to suppress automatic reactions. In conclusion, patients treated by DBS/STN tend to worsen in executive functions and in logical memory.

摘要

丘脑底核深部脑刺激术(DBS/STN)是晚期帕金森病(PD)运动症状的有效治疗方法。然而,DBS/STN如何影响认知功能尚不清楚。我们调查了19例接受双侧DBS/STN的帕金森病患者(13例男性,6例女性,平均年龄57±6岁,平均帕金森病病程15±4年)。在手术前和DBS植入后至少12个月进行神经心理学评估。在患者最佳运动状态下对其进行检查。采用马蒂斯痴呆评定量表测量的整体认知表现在DBS/STN术后无显著变化。韦氏记忆量表III中的逻辑记忆分测验、延迟回忆(p<0.05)和识别(p<0.05)成绩下降。在斯特鲁普测验中,测量干扰和抑制自动反应能力的第二项(p<0.05)和第三项条件(p<0.01)的成绩变差。总之,接受DBS/STN治疗的患者执行功能和逻辑记忆往往会恶化。

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