帕金森病患者丘脑底核脑深部电刺激术后冲动控制行为：新发病例与 3 年随访。
Impulse control behaviours in patients with Parkinson's disease after subthalamic deep brain stimulation: de novo cases and 3-year follow-up.
机构信息
Neurologia I, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands.
出版信息
J Neurol Neurosurg Psychiatry. 2015 May;86(5):562-4. doi: 10.1136/jnnp-2013-307214. Epub 2014 Jul 10.
OBJECTIVE
To document the occurrence of impulse control behaviours (ICBs) in patients with Parkinson's disease after 3 years of continuous deep brain stimulation (DBS) of the subthalamic nucleus (STN).
METHODS
Detailed neurological and ICB assessments were performed before STN DBS and up to 3 years after implant.
RESULTS
13 out of 56 patients (23.2%) had ICBs at baseline; they took higher doses of dopamine agonists (DAA). Three years after implant 11 had fully remitted with a 60.8% reduction of DAA medication; the remaining two, who had a similar medication reduction, had only compulsive eating, having recovered from hypersexuality. Six of the 43 patients without ICBs at baseline (14%) developed transient de novo ICBs after implant; none of them had ICBs at the 3-year observation.
CONCLUSIONS
ICBs were abolished in patients 3 years after STN DBS and DAA dosages were lowered. New ICBs may occur after implant and are transient in most cases. Compulsive eating may be specifically related to STN stimulation.
目的
记录经过 3 年连续丘脑底核（STN）脑深部电刺激（DBS）治疗后的帕金森病患者出现冲动控制行为（ICBs）的情况。
方法
在 STN-DBS 之前和植入后 3 年内进行详细的神经学和 ICB 评估。
结果
56 名患者中有 13 名（23.2%）基线时有 ICBs；他们服用了更高剂量的多巴胺激动剂（DAA）。植入 3 年后，11 名患者完全缓解，DAA 药物减少了 60.8%；其余 2 名患者的药物减少相似，但仅出现强迫性进食，已从性欲亢进中恢复。43 名基线时无 ICBs 的患者中有 6 名（14%）在植入后出现新发的短暂性 ICBs；在 3 年观察时，他们均无 ICBs。
结论
STN-DBS 治疗 3 年后，ICBs 被消除，DAA 剂量降低。新的 ICBs 可能在植入后发生，且在大多数情况下是短暂的。强迫性进食可能与 STN 刺激有特定关系。
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