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在中国粤语区特发性帕金森病患者中,丘脑底核深部脑刺激(STN-DBS)后即时言语记忆改善和类别流畅性降低的证据。

Evidence of improved immediate verbal memory and diminished category fluency following STN-DBS in Chinese-Cantonese patients with idiopathic Parkinson's disease.

作者信息

Tang Venus, Zhu Cannon X L, Chan Danny, Lau Claire, Chan Anne, Mok Vincent, Yeung Jonas, Poon Wai Sang

机构信息

Department of Clinical Psychology, Prince of Wales Hospital, Hospital Authority, Shatin, Hong Kong,

出版信息

Neurol Sci. 2015 Aug;36(8):1371-7. doi: 10.1007/s10072-015-2117-1. Epub 2015 Feb 24.

DOI:10.1007/s10072-015-2117-1
PMID:25708249
Abstract

The present study investigated the neuropsychological effects of bilateral deep brain stimulation (DBS) on subthalamic nucleus (STN) in Chinese-Cantonese patients with idiopathic Parkinson's disease (PD). Twenty-seven patients were prospectively recruited from the Movement Disorder Clinic at the Hong Kong Prince of Wales Hospital. Neuropsychological evaluations were performed at baseline, 6 and 12 months following the DBS procedure. Assessment battery included standardized tests on global cognitive function, verbal memory, non-verbal memory, confrontation naming, visuospatial organization, attention and executive functions. Anxiety and depressive symptoms were measured by two self-reported questionnaires. Results demonstrated diminished performance on a category fluency task that occurred at 6 months post-operatively and persisted at 12-month re-evaluation; 29.6-33.3 % of patients showed reduction of more than 1 SD (standard deviation) at post-operative measure. Conversely, performance on an immediate recall task in a verbal memory test was found to improve significantly at the same time point and persisted through 12 months after surgery; 22.2-25.9 % showed an improvement (≥1 SD). Psychologically, anxiety symptoms were statistically decreased and the significant reduction occurred at 12 months after surgery. Patients who reported a moderate to severe level of anxiety reduced from 51.9 to 18.5 %. Our findings concurred with most evidences on the effects of STN-DBS on verbal fluency; on the other hand, we demonstrated improvement of immediate verbal memory that warranted further investigation.

摘要

本研究调查了双侧脑深部电刺激(DBS)对以粤语为母语的中国特发性帕金森病(PD)患者丘脑底核(STN)的神经心理学影响。从香港威尔士亲王医院运动障碍诊所前瞻性招募了27名患者。在DBS手术前、术后6个月和12个月进行神经心理学评估。评估项目包括关于整体认知功能、言语记忆、非言语记忆、对名命名、视觉空间组织、注意力和执行功能的标准化测试。焦虑和抑郁症状通过两份自我报告问卷进行测量。结果显示,术后6个月出现的类别流畅性任务表现下降在12个月重新评估时持续存在;29.6 - 33.3%的患者在术后测量时表现下降超过1个标准差(SD)。相反,在言语记忆测试中的即时回忆任务表现同时显著改善,并在术后12个月持续存在;22.2 - 25.9%的患者表现出改善(≥1个标准差)。在心理方面,焦虑症状在统计学上有所下降,且在术后12个月出现显著下降。报告中度至重度焦虑水平的患者从51.9%降至18.5%。我们的研究结果与大多数关于STN - DBS对言语流畅性影响的证据一致;另一方面,我们证明了即时言语记忆的改善,这值得进一步研究。

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