双侧丘脑底核刺激对帕金森病患者决策的急性影响。
Acute effects of bilateral subthalamic stimulation on decision-making in Parkinson's disease.
机构信息
Department of Neurology, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan.
出版信息
Parkinsonism Relat Disord. 2011 Mar;17(3):189-93. doi: 10.1016/j.parkreldis.2010.12.004. Epub 2011 Jan 26.
BACKGROUND
Pathological gambling can develop in Parkinson's disease (PD), and impairment of decision-making may play an important role in the mechanism. To assess acute effects of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on decision-making, patients with PD who were eligible for STN-DBS were evaluated using the Iowa Gambling Task (IGT).
METHODS
The study participants were 16 patients with PD who underwent bilateral STN-DBS, and 16 age-matched control patients with PD. The participants performed the IGT pre-operatively and 2-4 weeks post-operatively with on- and off-stimulation. Participants' one hundred card selections were divided into five blocks of 20 cards each.
RESULTS
The total IGT score was not significantly different before surgery, on-stimulation or off-stimulation, but DBS patients tended to perform worse in the on-DBS session compared to off-DBS session (P = 0.019) only in the last block of the task. The IGT score did not correlate with levodopa equivalent dose or performance on the measures of executive function, but did correlate with self-reported depression symptoms, and active contact of stimulation.
CONCLUSION
Bilateral STN-DBS may affect decision-making in acute post-operative stage.
背景
病理性赌博可能在帕金森病（PD）中发展，而决策受损可能在发病机制中起重要作用。为了评估双侧丘脑底核深部脑刺激（STN-DBS）对决策的急性影响，对符合 STN-DBS 条件的 PD 患者使用 Iowa 赌博任务（IGT）进行了评估。
方法
研究参与者为 16 名接受双侧 STN-DBS 的 PD 患者和 16 名年龄匹配的 PD 对照患者。参与者在术前、刺激开启和关闭时进行 IGT。参与者的一百张卡片选择分为五个 20 张卡片的块。
结果
总 IGT 评分在术前、刺激开启和关闭时均无显著差异，但 DBS 患者在任务的最后一个块中，与刺激关闭时相比，刺激开启时的表现更差（P = 0.019）。IGT 评分与左旋多巴等效剂量或执行功能测量结果无关，但与自我报告的抑郁症状和刺激的主动接触有关。
结论
双侧 STN-DBS 可能会影响术后急性阶段的决策。
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