Antosik-Wójcińska Anna, Święcicki Łukasz, Dominiak Monika, Sołtan Emilia, Bieńkowski Przemyslaw, Mandat Tomasz
Institute of Psychiatry and Neurology, Department of Affective Disorders, Poland.
Institute of Psychiatry and Neurology, Department of Affective Disorders, Poland.
J Neurol Sci. 2017 Apr 15;375:342-347. doi: 10.1016/j.jns.2017.02.020. Epub 2017 Feb 9.
DBS is a surgical method of choice for various movement disorders, especially for Parkinson's disease (PD). Many publications showing improvement in motor symptoms and quality of life have been presented while there is little comprehensive research evaluation of the impact of DBS on mental state and psychiatric side-effects.
The purpose of this study was to assess the impact of DBS on mood, drive, anhedonia and psychotic symptoms in the group of PD patients.
60 patients with PD were treated with STN-DBS. Mental state and psychiatric side effects were assessed with the use of MADRS, HADRS, BDI, BPRS, YMS, SHAPS, CGI and PGI rating scales. Evaluation was performed five times in the period from the day before surgery to six months after implantation of the DBS.
This study showed an improvement of mood, which has followed within a month after the start of stimulation and manifested in MADRS, HADRS, BDI scores reduction. The trend towards improvement was maintained over the following 6months. No manic episodes appeared, 2 cases of mild hypomania were observed. Psychotic symptoms occurred in 1 patient. Anhedonia reduction observed during the first 30days after initiating the stimulation persisted in the assessment six months after implantation of the DBS.
The survey results confirm the effect of stimulation on mood, drive, ability to feel pleasure. Psychiatric side effects such as phase change were rare and mild, while psychotic symptoms that occurred in one patient ware manageable through medication. Further intensive research in this topic are required.
脑深部电刺激术（DBS）是治疗各种运动障碍，尤其是帕金森病（PD）的首选手术方法。许多文献表明其可改善运动症状和生活质量，但对于DBS对精神状态和精神副作用的影响，目前几乎没有全面的研究评估。
本研究旨在评估DBS对帕金森病患者情绪、动力、快感缺失及精神症状的影响。
60例帕金森病患者接受了丘脑底核脑深部电刺激术（STN-DBS）治疗。使用蒙哥马利-艾森伯格抑郁评定量表（MADRS）、医院焦虑抑郁量表（HADRS）、贝克抑郁量表（BDI）、简明精神病评定量表（BPRS）、杨氏躁狂量表（YMS）、简明快感缺失量表（SHAPS）、临床总体印象量表（CGI）和患者总体印象量表（PGI）评定量表评估精神状态和精神副作用。在手术前一天至脑深部电刺激器植入后6个月期间进行了5次评估。
本研究显示情绪有所改善，在开始刺激后1个月内出现，表现为MADRS、HADRS、BDI评分降低。在接下来的6个月中，改善趋势得以维持。未出现躁狂发作，观察到2例轻度轻躁狂。1例患者出现精神症状。在开始刺激后的前30天观察到的快感缺失减少在脑深部电刺激器植入后6个月的评估中持续存在。
调查结果证实了刺激对情绪、动力、感受愉悦能力的影响。诸如相转变等精神副作用罕见且轻微，而1例患者出现的精神症状可通过药物控制。需要对该主题进行进一步深入研究。
