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双侧丘脑底核刺激对帕金森病认知和神经精神功能的影响:一项病例对照研究(#)

The effects of bilateral subthalamic nucleus stimulation on cognitive and neuropsychiatric functions in Parkinson's disease: a case-control study (#).

作者信息

Mahdavi Reza, Malakouti Seyed Kazem, Shahidi Gholam Ali, Parvaresh-Rizi Mansour

机构信息

Mental Health Research Center, Tehran Psychiatric Institute, Tehran University of Medical Science, Tehran, Iran.

Tehran Psychiatric Institute- Tehran University of Medical Science, Tehran, Iran.

出版信息

Basic Clin Neurosci. 2013 Summer;4(3):217-23.

Abstract

INTRODUCTION

Parkinson's disease is one of the most disabling diseases which by electrode implantation and stimulation of subthalamic nucleus (STN), much progress has been made in the treatment of drug resistant patient. This new method of neurosurgery may have some neuropsychological side effects on the patients. The main aim of this study is to evaluate the effects of this kind of treatment on the different neuropsychological aspect of patients.

METHODS

The case-control study designed for comparing two groups of patients with Parkinson's disease. Thirty patients, who underwent electrode implantation and Deep Brain Stimulation (DBS), compare with 60 patients treated with antiparkinson's drugs. These two groups matched in age, sex, Parkinson's disease duration and Parkinson's severity scores.

MEASUREMENTS

the UPDR scale was used to assess the severity of the Parkinson's severity. Beck Depression Inventory questionnaire (BDI) and Hamilton Anxiety Rating Scale questionnaire (HARS) were used to evaluate the depression and anxiety consequences of DBS. Mini Mental Status Examination (MMSE) and Clock Drawing Test (CDT) were used to evaluate the cognitive and executive function of the study subjects.

RESULTS

Patients with STN stimulation showed lower level of anxiety and depression, however, the cognitive status were more deteriorated in study subjects than control group.

DISCUSSION

Patient with DBS surgery have to be followed up for neuropsychiatric symptoms particularly for the cognitive deterioration in long term period.

摘要

引言

帕金森病是最致残的疾病之一,通过电极植入和刺激丘脑底核(STN),在治疗耐药患者方面已取得很大进展。这种神经外科新方法可能会给患者带来一些神经心理副作用。本研究的主要目的是评估这种治疗方法对患者不同神经心理方面的影响。

方法

采用病例对照研究设计,比较两组帕金森病患者。30例接受电极植入和脑深部电刺激(DBS)的患者与60例接受抗帕金森病药物治疗的患者进行比较。这两组在年龄、性别、帕金森病病程和帕金森病严重程度评分方面相匹配。

测量

采用统一帕金森病评定量表(UPDR)评估帕金森病的严重程度。使用贝克抑郁量表问卷(BDI)和汉密尔顿焦虑评定量表问卷(HARS)评估DBS的抑郁和焦虑后果。使用简易精神状态检查表(MMSE)和画钟试验(CDT)评估研究对象的认知和执行功能。

结果

接受STN刺激的患者焦虑和抑郁水平较低,然而,研究对象的认知状态比对照组恶化得更严重。

讨论

接受DBS手术的患者必须长期随访神经精神症状,尤其是认知功能恶化情况。

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Complications of deep brain stimulation: a collective review.深部脑刺激的并发症:综合述评。
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