Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
Eur Neurol. 2010;63(3):176-9. doi: 10.1159/000289097. Epub 2010 Feb 27.
A higher risk of suicidal attempt after subthalamic nucleus deep brain stimulation (STN-DBS) for Parkinson's disease (PD) has been consistently reported. We retrospectively analyzed 3 PD patients with suicide attempts after STN-DBS. All patients had normal pre- and immediate postoperative psychopathological and cognitive evaluations, with STN-DBS yielding a good motor benefit. Levodopa medication was markedly reduced. Albeit there was a significant reduction in dopaminergic medication, there was also a considerable time lag to suicide attempt. Impulsive behavior could have played a higher role, going unnoticed in punctual psychopathological examinations. STN-DBS patients need a closer postoperative psychiatric and behavioral follow-up.
已有研究一致报道,深部脑刺激术(DBS)治疗帕金森病(PD)后,自杀尝试的风险更高。我们回顾性分析了 3 例接受丘脑底核 DBS 后自杀尝试的 PD 患者。所有患者术前和术后即刻的精神病理学和认知评估均正常,STN-DBS 产生了良好的运动获益,左旋多巴药物明显减少。尽管多巴胺能药物显著减少,但自杀尝试也有相当长的时间延迟。冲动行为可能起了更高的作用,在及时的精神病理学检查中未被注意到。STN-DBS 患者需要更密切的术后精神和行为随访。