Janssen Marcus L F, Duits Annelien A, Turaihi Ali H, Ackermans Linda, Leentjens Albert F G, Leentjes Albert F G, van Kranen-Mastenbroek Vivianne, Oosterloo Mayke, Visser-Vandewalle Veerle, Temel Yasin
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
Stereotact Funct Neurosurg. 2014;92(6):381-7. doi: 10.1159/000366066. Epub 2014 Oct 29.
Since the introduction of subthalamic nucleus deep brain stimulation (STN DBS), many clinical studies have shown that this therapy is safe and effective in the short and medium term. Only little is known about long-term results.
To provide an analysis of motor and cognitive outcome 10 years after STN DBS.
In this observational cohort study, we report on the motor and cognitive outcome in a cohort of 26 Parkinson's disease patients who were prospectively followed up for 10 years after STN DBS surgery.
In the early post-operative phase, improvement in the Unified Parkinson's Disease Rating Scale (UPDRS) III (10.6, p < 0.01) and IV (2.5, p < 0.01) was seen as well as a 32% reduction in levodopa equivalent dose (p < 0.01). After 5 years, a worsening of the motor performance was observed. The worsening of motor performance was mainly due to a deterioration in bradykinesia (12.4 ± 4.6, p < 0.05) and axial symptoms (6.9 ± 2.8, p < 0.01). Memory function seemed to improve in the short term, but there was a significant decline between 1 and 5 years after surgery (p < 0.01). Mood remained relatively stable during follow-up, and one third of the patients showed impulsive behaviour after surgery.
The motor performance of patients showed deterioration over time, due to an increase in bradykinesia and axial symptoms.
自丘脑底核深部脑刺激术（STN DBS）引入以来，许多临床研究表明，该疗法在短期和中期是安全有效的。关于长期效果的了解却很少。
分析STN DBS术后10年的运动和认知结果。
在这项观察性队列研究中，我们报告了26例帕金森病患者在接受STN DBS手术后进行前瞻性随访10年的运动和认知结果。
术后早期，统一帕金森病评定量表（UPDRS）Ⅲ（改善10.6，p<0.01）和Ⅳ（改善2.5，p<0.01）有所改善，左旋多巴等效剂量降低了32%（p<0.01）。5年后，观察到运动表现恶化。运动表现的恶化主要归因于运动迟缓（12.4±4.6，p<0.05）和轴性症状（6.9±2.8，p<0.01）的恶化。记忆功能在短期内似乎有所改善，但术后1至5年出现显著下降（p<0.01）。随访期间情绪保持相对稳定，三分之一的患者术后出现冲动行为。
由于运动迟缓和轴性症状增加，患者的运动表现随时间推移而恶化。
