采用脑深部电刺激治疗冲动控制障碍：一把双刃剑。
Management of impulse control disorders with deep brain stimulation: A double-edged sword.
作者信息
Kasemsuk Chayut, Oyama Genko, Hattori Nobutaka
机构信息
Department of Neurology, Juntendo University, Faculty of Medicine, Tokyo, Japan; Department of Neurology, Prasat Neurological Institute, Bangkok, Thailand.
Department of Neurology, Juntendo University, Faculty of Medicine, Tokyo, Japan.
出版信息
J Neurol Sci. 2017 Mar 15;374:63-68. doi: 10.1016/j.jns.2017.01.019. Epub 2017 Jan 7.
Deep brain stimulation (DBS) is a surgical option for advanced Parkinson's disease. Although DBS is used to treat motor fluctuation, DBS may affect non-motor symptoms including mood disorders, cognitive dysfunction, and behavior problems. Impulse control disorders (ICDs) are abnormal behaviors with various manifestations such as pathological gambling, hypersexuality, compulsive shopping, and binge eating, which can affect the quality of life in patients with Parkinson's disease. The effect of DBS on ICD is controversial. Reducing medication by DBS may improve ICDs, however, worsening or even developing new ICDs after DBS can occur. We will review the impact of DBS on ICDs and reveal factors associated with a good response to DBS as well as risk factors for developing ICDs after DBS. We also propose a strategy to manage preexisting ICD and prevent postoperative de novo ICDs.
脑深部电刺激术（DBS）是晚期帕金森病的一种手术治疗选择。尽管DBS用于治疗运动波动，但它可能会影响非运动症状，包括情绪障碍、认知功能障碍和行为问题。冲动控制障碍（ICD）是具有多种表现形式的异常行为，如病理性赌博、性欲亢进、强迫购物和暴饮暴食，这些会影响帕金森病患者的生活质量。DBS对ICD的影响存在争议。通过DBS减少药物用量可能会改善ICD，但也可能出现DBS后ICD恶化甚至出现新的ICD的情况。我们将综述DBS对ICD的影响，揭示与DBS良好反应相关的因素以及DBS后发生ICD的危险因素。我们还提出了一种管理既往存在的ICD并预防术后新发ICD的策略。
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