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帕金森病中的苍白球刺激不会诱发冷漠。

Pallidal stimulation in Parkinson's disease does not induce apathy.

作者信息

Lozachmeur Clément, Drapier Sophie, Robert Gabriel, Dondaine Thibaut, Laviolle Bruno, Sauleau Paul, Peron Julie, Le Jeune Florence, Travers David, Millet Bruno, Vérin Marc, Drapier Dominique

出版信息

J Neuropsychiatry Clin Neurosci. 2014 Summer;26(3):221-6. doi: 10.1176/appi.neuropsych.13020032.

Abstract

BACKGROUND

Whereas apathy is known as a common consequence of subthalamic nucleus deep brain stimulation in Parkinson's disease, few studies have investigated the psychiatric consequences of internal globus pallidus deep brain stimulation.

METHOD

Twenty consecutive parkinsonian patients who underwent bilateral pallidal stimulation were assessed 3 months prior to surgery (M‒3) and at both 3 (M3) and 6 months (M6) after surgery, using psychiatric, neuropsychological, and motor scales. Apathy, mood state, and anxiety state were scored using the Apathy Evaluation Scale, the Montgomery-Åsberg Depression Rating Scale, and the anxiety scale from the Association for Methodology and Documentation in Psychiatry, respectively.

RESULTS

The mean apathy score remained stable between the preoperative M‒3 assessment (37.2±6.2) and both the postoperative M3 (36.9±7.5) and M6 (37.2±5.0) assessments. The mean depression score did not differ between the M‒3 assessment and M3 and M6 assessments. There was no difference between the preoperative mean anxiety score and both the postoperative M3 and M6 scores. The mean score for the Mattis Dementia Rating Scale remained stable at each study visit.

CONCLUSIONS

The main result of this study is the absence of deterioration in psychiatric and cognitive scores 3 months and 6 months after pallidal stimulation.

摘要

背景

虽然淡漠被认为是帕金森病丘脑底核深部脑刺激的常见后果,但很少有研究调查苍白球内侧部深部脑刺激的精神后果。

方法

对连续20例接受双侧苍白球刺激的帕金森病患者在手术前3个月(M‒3)以及手术后3个月(M3)和6个月(M6)进行评估,使用精神科、神经心理学和运动量表。分别使用淡漠评估量表、蒙哥马利-Åsberg抑郁评定量表和精神科方法与文献协会的焦虑量表对淡漠、情绪状态和焦虑状态进行评分。

结果

术前M‒3评估时的平均淡漠评分(37.2±6.2)与术后M3(36.9±7.5)和M6(37.2±5.0)评估时的平均淡漠评分保持稳定。M‒3评估与M3和M6评估之间的平均抑郁评分无差异。术前平均焦虑评分与术后M3和M6评分之间无差异。马蒂斯痴呆评定量表的平均评分在每次研究访视时均保持稳定。

结论

本研究的主要结果是苍白球刺激后3个月和6个月精神和认知评分没有恶化。

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