Mehanna Raja, Bajwa Jawad A, Fernandez Hubert, Wagle Shukla Aparna Ashutosh
University of Texas Health Science Center, Houston, TX, USA.
Parkinson's, Movement Disorders and Neurorestoration Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.
Parkinsons Dis. 2017;2017:3085140. doi: 10.1155/2017/3085140. Epub 2017 Nov 22.
Subthalamic nucleus (STN) or globus pallidus interna (GPi) deep brain stimulation (DBS) is considered a robust therapeutic tool in the treatment of Parkinson's disease (PD) patients, although it has been reported to potentially cause cognitive decline in some cases. We here provide an in-depth and critical review of the current literature regarding cognition after DBS in PD, summarizing the available data on the impact of STN and GPi DBS as monotherapies and also comparative data across these two therapies on 7 cognitive domains. We provide evidence that, in appropriately screened PD patients, worsening of one or more cognitive functions is rare and subtle after DBS, without negative impact on quality of life, and that there is very little data supporting that STN DBS has a worse cognitive outcome than GPi DBS.
丘脑底核(STN)或内侧苍白球(GPi)深部脑刺激(DBS)被认为是治疗帕金森病(PD)患者的一种有效治疗手段,尽管有报道称在某些情况下它可能会导致认知功能下降。我们在此对当前关于PD患者DBS术后认知的文献进行深入且批判性的综述,总结关于STN和GPi DBS作为单一疗法的影响的现有数据,以及这两种疗法在7个认知领域的比较数据。我们提供的证据表明,在经过适当筛选的PD患者中,DBS术后一种或多种认知功能恶化的情况很少见且很轻微,对生活质量没有负面影响,而且几乎没有数据支持STN DBS的认知结果比GPi DBS更差。