帕金森病中接受丘脑底核深部脑刺激的老年患者发生精神方面严重不良事件的发生率更高。
Older Candidates for Subthalamic Deep Brain Stimulation in Parkinson's Disease Have a Higher Incidence of Psychiatric Serious Adverse Events.
作者信息
Cozac Vitalii V, Ehrensperger Michael M, Gschwandtner Ute, Hatz Florian, Meyer Antonia, Monsch Andreas U, Schuepbach Michael, Taub Ethan, Fuhr Peter
机构信息
Department of Neurology, Hospital of the University of Basel Basel, Switzerland.
Memory Clinic, Felix Platter Hospital, University Center for Medicine of Aging Basel, Switzerland.
出版信息
Front Aging Neurosci. 2016 Jun 8;8:132. doi: 10.3389/fnagi.2016.00132. eCollection 2016.
OBJECTIVE
To investigate the incidence of serious adverse events (SAE) of subthalamic deep brain stimulation (STN-DBS) in elderly patients with Parkinson's disease (PD).
METHODS
We investigated a group of 26 patients with PD who underwent STN-DBS at mean age 63.2 ± 3.3 years. The operated patients from the EARLYSTIM study (mean age 52.9 ± 6.6) were used as a comparison group. Incidences of SAE were compared between these groups.
RESULTS
A higher incidence of psychosis and hallucinations was found in these elderly patients compared to the younger patients in the EARLYSTIM study (p < 0.01).
CONCLUSIONS
The higher incidence of STN-DBS-related psychiatric complications underscores the need for comprehensive psychiatric pre- and postoperative assessment in older DBS candidates. However, these psychiatric SAE were transient, and the benefits of DBS clearly outweighed its adverse effects.
目的
探讨丘脑底核深部脑刺激术（STN-DBS）在老年帕金森病（PD）患者中严重不良事件（SAE）的发生率。
方法
我们调查了一组平均年龄为63.2±3.3岁且接受STN-DBS手术的26例PD患者。将EARLYSTIM研究中的手术患者（平均年龄52.9±6.6岁）作为对照组。比较两组间SAE的发生率。
结果
与EARLYSTIM研究中的年轻患者相比，这些老年患者出现精神病和幻觉的发生率更高（p<0.01）。
结论
STN-DBS相关精神并发症的较高发生率凸显了对年龄较大的DBS候选者进行全面的术前和术后精神评估的必要性。然而，这些精神方面的SAE是短暂的，且DBS的益处明显超过其不良影响。
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