帕金森病的非运动性结果：深部脑刺激是否优于多巴胺替代疗法？
Nonmotor outcomes in Parkinson's disease: is deep brain stimulation better than dopamine replacement therapy?
出版信息
Ther Adv Neurol Disord. 2012 Jan;5(1):23-41. doi: 10.1177/1756285611423412.
Abstract
Nonmotor symptoms are an integral part of Parkinson's disease and cause significant morbidity. Pharmacological therapy helps alleviate the disease but produces nonmotor manifestations. While deep brain stimulation (DBS) has emerged as the treatment of choice for motor dysfunction, the effect on nonmotor symptoms is not well known. Compared with pharmacological therapy, bilateral subthalamic nucleus (STN)-DBS or globus pallidum interna (GPi)-DBS has significant beneficial effects on pain, sleep, gastrointestinal and urological symptoms. STN-DBS is associated with a mild worsening in verbal fluency while GPi-DBS has no effect on cognition. STN-DBS may improve cardiovascular autonomic disturbances by reducing the dose of dopaminergic drugs. Because the motor effects of STN-DBS and GPi-DBS appear to be similar, nonmotor symptoms may determine the target choice in surgery of future patients.
摘要
非运动症状是帕金森病的一个组成部分，会导致显著的发病率。药物治疗有助于缓解疾病，但会产生非运动表现。虽然深部脑刺激 (DBS) 已成为运动功能障碍的治疗选择，但对非运动症状的影响尚不清楚。与药物治疗相比，双侧丘脑底核 (STN)-DBS 或苍白球内 (GPi)-DBS 对疼痛、睡眠、胃肠道和泌尿系统症状有显著的有益影响。STN-DBS 与言语流畅性轻度恶化相关，而 GPi-DBS 对认知没有影响。STN-DBS 通过减少多巴胺能药物的剂量可能改善心血管自主功能障碍。由于 STN-DBS 和 GPi-DBS 的运动效果似乎相似，因此非运动症状可能决定未来患者手术的目标选择。
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