Tang Venus, Zhu Cannon X L, Chan Danny, Lau Claire, Chan Anne, Mok Vincent, Yeung Jonas, Poon Wai Sang
Department of Clinical Psychology, Prince of Wales Hospital, Hospital Authority, Shatin, Hong Kong,
Neurol Sci. 2015 Aug;36(8):1371-7. doi: 10.1007/s10072-015-2117-1. Epub 2015 Feb 24.
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.
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。