Foki Thomas, Hitzl Daniela, Pirker Walter, Novak Klaus, Pusswald Gisela, Auff Eduard, Lehrner Johann
Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria.
Department of Neurology, Wilhelminenspital Wien, Vienna, Austria.
Wien Klin Wochenschr. 2017 Aug;129(15-16):564-571. doi: 10.1007/s00508-017-1169-z. Epub 2017 Feb 7.
Long-term therapy of Parkinson's disease with L‑DOPA is associated with a high risk of developing motor fluctuations and dyskinesia. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can improve these motor complications. Although the positive effect on motor symptoms has been proven, postoperative cognitive decline has been documented. To tackle the impact of DBS on cognition, 18 DBS patients were compared to 25 best medically treated Parkinson's patients, 24 patients with mild cognitive impairment (MCI) and 12 healthy controls using the Neuropsychological Test Battery Vienna short version (NTBV-short) for cognitive outcome 12 months after the first examination. Reliable change index methodology was used. Roughly 10% of DBS patients showed cognitive decline mainly affecting the domains attention and executive functioning (phonemic fluency). Further research is needed to identify the mechanisms that lead to improvement or deterioration of cognitive functions in individual cases.
长期使用左旋多巴治疗帕金森病会有出现运动波动和异动症的高风险。丘脑底核(STN)的深部脑刺激(DBS)可改善这些运动并发症。尽管已证实其对运动症状有积极作用,但术后认知功能下降也有记录。为了应对DBS对认知的影响,使用维也纳神经心理测试组合简版(NTBV-short)对18例接受DBS治疗的患者与25例接受最佳药物治疗的帕金森病患者、24例轻度认知障碍(MCI)患者和12例健康对照者进行了比较,以评估首次检查后12个月的认知结果。采用了可靠变化指数方法。约10%的DBS患者出现认知功能下降,主要影响注意力和执行功能(语音流畅性)领域。需要进一步研究以确定导致个别病例认知功能改善或恶化的机制。