Groth Christopher L, Pusso Antonia, Sperling Scott A, Huss Diane S, Elias W Jeffrey, Wooten G Frederick, Barrett Matthew J
From the Department of Neurology, University of Virginia, Charlottesville, Va. (CLG, SAS, GFW, MJB); the School of Medicine, University of Virginia, Charlottesville, Va. (AP); the Department of Physical Therapy, University of Virginia, Charlottesville, Va. (DSH); and the Department of Neurosurgery, University of Virginia, Charlottesville, Va. (WJE).
J Neuropsychiatry Clin Neurosci. 2018 Spring;30(2):160-163. doi: 10.1176/appi.neuropsych.17030052. Epub 2017 Nov 14.
Psychosis is common in Parkinson's disease (PD), especially in advanced disease, and can lead to a number of psychotic symptoms, including delusions. One uncommon delusion is Capgras syndrome (CS). The authors report on three PD patients with a history of deep brain stimulation (DBS) who developed this delusion. The anatomic targets in these three patients were the subthalamic nuclei in two patients and the globus pallidus interna in one patient. The length of time between surgery and development of CS varied but was greater than 6 months. Additionally, all three patients showed evidence of impaired cognition prior to development of CS. Therefore, due to the length of time between DBS and CS in all three cases and the fact that one patient developed CS months after DBS explanation, DBS does not appear to be associated with CS. Given the distressing nature of this condition, patients with advanced PD who undergo DBS should be regularly screened for symptoms of psychosis with awareness of CS as a potential form.
精神病在帕金森病（PD）中很常见，尤其是在疾病晚期，并且会导致多种精神症状，包括妄想。一种不常见的妄想是卡普格拉综合征（CS）。作者报告了3例有脑深部电刺激（DBS）病史的PD患者出现了这种妄想。这3例患者的解剖靶点，2例是丘脑底核，1例是内侧苍白球。手术与CS发生之间的时间长短不一，但超过了6个月。此外，所有3例患者在CS发生之前均有认知障碍的证据。因此，鉴于所有3例中DBS与CS之间的时间间隔，以及1例患者在DBS术后数月出现CS这一事实，DBS似乎与CS无关。鉴于这种情况令人痛苦的性质，接受DBS治疗的晚期PD患者应定期筛查精神病症状，并意识到CS是一种可能的形式。
