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深部脑刺激对帕金森病患者的驾驶能力有帮助吗?

Could deep brain stimulation help with driving for patients with Parkinson's?

作者信息

Buhmann Carsten, Gerloff Christian

机构信息

Department of Neurology, University Medical Center, Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.

出版信息

Expert Rev Med Devices. 2014 Sep;11(5):427-9. doi: 10.1586/17434440.2014.929495. Epub 2014 Jun 14.

Abstract

For mobility impaired people with Parkinson's disease (PD), driving a car is important to maintain independency. But driving ability is getting worse with disease progression. Meanwhile surgical treatment with deep brain stimulation (DBS) of the subthalamic nucleus is done routinely in advanced PD, but it is unknown how DBS might affect driving. In a driving simulator setting, we found PD patients undergone DBS surgery to drive safer than even less clinically affected PD patients treated with medication alone. Furthermore, patients with DBS surgery drove better under stimulation than under medication. In conclusion, DBS of the subthalamic nucleus appears to be beneficial for driving in PD patients, potentially due to non-motor effects on controlling the vehicle in the simulator setting. Nevertheless, results of this first pilot study on driving in PD patients with DBS should not encourage patients or physicians to consider DBS only to improve or regain driving competence.

摘要

对于患有帕金森病(PD)且行动不便的人来说,开车对于维持独立性很重要。但随着疾病进展,驾驶能力会逐渐下降。同时,丘脑底核的深部脑刺激(DBS)手术在晚期帕金森病中已常规开展,但尚不清楚DBS如何影响驾驶。在驾驶模拟器环境中,我们发现接受DBS手术的帕金森病患者比仅接受药物治疗、临床症状较轻的帕金森病患者驾驶得更安全。此外,接受DBS手术的患者在刺激状态下比在药物治疗状态下驾驶得更好。总之,丘脑底核的DBS似乎对帕金森病患者的驾驶有益,这可能是由于在模拟器环境中对控制车辆有非运动效应。然而,这项关于帕金森病DBS患者驾驶的首次初步研究结果不应鼓励患者或医生仅为改善或恢复驾驶能力而考虑DBS。

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