Department of Psychiatry and Neurosciences, University of South Florida College of Medicine, Florida, USA.
Clin Neuropsychol. 2012;26(2):255-70. doi: 10.1080/13854046.2011.653587. Epub 2012 Feb 14.
Parkinson's disease (PD) is progressive neurological disease characterized by resting tremor, rigidity, akinesia, postural instability and cognitive changes. The symptoms of PD are debilitating and often become unsatisfactorily treated by medication. Deep brain stimulation (DBS) is an effective treatment to significantly reduce the cardinal motor symptoms of PD. However, the neuropsychological effects of this treatment are less clear. This study examined pre- to post-DBS scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) using Reliable Change Indices (RCIs) derived from 20 patients with PD who were medically managed, and then compared to 20 patients with PD treated with DBS and medication. When using group statistical analyses and false discovery rate correction, no significant differences between or within groups were evident at baseline or at follow-up. However, when using the RCIs more patients in the DBS group exhibited reliable change in RBANS scores than did the Med Tx group. Although preliminary, these RCIs provide clinicians and researchers a foundational tool for assessing the effects of interventions (e.g., DBS) independent of the effects of PD and measurement error when using the RBANS.
帕金森病(PD)是一种进行性神经疾病,其特征是静止性震颤、僵直、运动迟缓、姿势不稳和认知改变。PD 的症状使人衰弱,且常因药物治疗效果不佳而无法得到有效缓解。脑深部电刺激(DBS)是一种有效的治疗方法,可显著减轻 PD 的主要运动症状。然而,这种治疗的神经心理学效应尚不清楚。本研究使用来自 20 名接受药物治疗的 PD 患者的可重复性成套神经心理状态测验(RBANS)的可靠变化指数(RCIs),对 DBS 治疗前后的 RBANS 评分进行了检查,然后将其与接受 DBS 和药物治疗的 20 名 PD 患者进行了比较。使用组统计分析和假发现率校正时,在基线或随访时,组间或组内均未显示出显著差异。然而,使用 RCIs 时,DBS 组中比药物治疗组中更多的患者在 RBANS 评分上表现出可靠变化。尽管这些 RCIs 初步提供了一种临床医生和研究人员的基础工具,用于在使用 RBANS 时,独立于 PD 和测量误差评估干预措施(例如 DBS)的效果。