Division of Neurodegenerative Diseases, Department of Neurology, Dresden University of Technology, Fetscherstrasse 74,Dresden, Germany.
Parkinsonism Relat Disord. 2012 Sep;18(8):994-7. doi: 10.1016/j.parkreldis.2012.05.011. Epub 2012 Jun 7.
To assess the immediate effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) on nonmotor symptoms (NMS) in Parkinson's disease (PD).
Immediate effects of STN-DBS on motor functions are well accepted, but similar data on NMS are mainly lacking.
34 PD patients who received bilateral STN-DBS were examined in medication Off state for frequency and severity of 10 NMS (dysphagia, anxiety, depression, fatigue, excessive sweating, inner restlessness, pain, concentration/attention, dizziness, bladder urgency) using a visual analogue scale (VAS) with STN-DBS Off and On. Motor assessments were done using UPDRS part III.
Independent of STN-DBS status, most frequent NMS was fatigue (85% of patients), followed by problems with concentration/attention (71%) and inner restlessness (53%). Frequencies of most NMS were similar in both STN-DBS statuses, while only inner restlessness was significantly decreased by STN-DBS. Severities of most NMS were significantly improved by STN-DBS on the cohort level, while only excessive sweating, pain and dizziness did not show significant severity changes. However, variable proportions of patients (15-71%, depending on the NMS) reported relevant improvements (>10% on VAS) by STN-DBS with fatigue showing the largest proportion of patients with symptom improvement (71%). There were no correlations of severity changes of NMS with motor improvement, demographic data and medication.
STN-DBS does not have major immediate effects on frequencies of NMS, but improves most NMS particularly psychiatric symptoms such as depression, anxiety and fatigue in a variable subset of patients. There is no indication that STN-DBS worsens NMS.
评估丘脑底核（STN）深部脑刺激（DBS）对帕金森病（PD）非运动症状（NMS）的即刻影响。
STN-DBS 对运动功能的即刻影响已被广泛接受，但类似的 NMS 数据主要缺乏。
34 例接受双侧 STN-DBS 的 PD 患者在药物停用状态下，使用视觉模拟量表（VAS），分别评估 STN-DBS 停用和启用时 10 种 NMS（吞咽困难、焦虑、抑郁、疲劳、过度出汗、内心不安、疼痛、注意力/注意力、头晕、尿急）的频率和严重程度。运动评估采用 UPDRS 第三部分。
无论 STN-DBS 状态如何，最常见的 NMS 是疲劳（85%的患者），其次是注意力/注意力问题（71%）和内心不安（53%）。大多数 NMS 的发生频率在两种 STN-DBS 状态下相似，而只有内心不安在 STN-DBS 下显著减少。在队列水平上，大多数 NMS 的严重程度都因 STN-DBS 而显著改善，而只有过度出汗、疼痛和头晕的严重程度没有显著变化。然而，有不同比例的患者（15-71%，取决于 NMS）报告 STN-DBS 有相关改善（VAS 上>10%），其中疲劳的患者改善比例最大（71%）。NMS 严重程度的变化与运动改善、人口统计学数据和药物之间没有相关性。
STN-DBS 对 NMS 的发生频率没有显著影响，但可改善大多数 NMS，特别是抑郁、焦虑和疲劳等精神症状，在不同的患者亚组中。STN-DBS 没有恶化 NMS 的迹象。
