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深部脑刺激对帕金森病患者生活质量和吞咽功能的影响。

The Impact of Deep Brain Stimulation on the Quality of Life and Swallowing in Individuals with Parkinson's Disease.

作者信息

Olchik Maira Rozenfel, Ghisi Marciéle, Ayres Annelise, Schuh Arthur Francisco Shumacher, Oppitz Paulo Petry, Rieder Carlos Roberto de Mello

机构信息

Departament of Surgery and Orthopedics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Graduation in Speech Therapy, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

出版信息

Int Arch Otorhinolaryngol. 2018 Apr;22(2):125-129. doi: 10.1055/s-0037-1603466. Epub 2017 Jun 5.

Abstract

Deep brain stimulation (DBS) is an established treatment for Parkinson's disease (PD). However, there is little evidence regarding the effect of DBS on dysphagia.  To assess the swallowing and quality of life of individuals with PD before and after DBS surgery.  Our sample consisted of people who had undergone DBS surgery in a referral hospital in the state of Rio Grande do Sul, Brazil. The inclusion criteria were a diagnosis of PD and having undergone DBS surgery. A cognitive screening, through a questionnaire about depression and quality of life, was conducted. Evaluations of each patient's swallowing were performed before and after surgery. The assessment consisted of anamnesis, clinical assessment, the Functional Oral Intake Scale, clinical evaluation of swallowing, and the Hoehn and Yahr scale.  The sample included 10 individuals, all male, with a mean age of 57.3 years (±4.7), a mean disease duration of 13.0 years (±2.4), and mean level education of 8.1 years (±4.0). In the clinical evaluation of the swallowing, a significant improvement after DBS was not observed. However, little changes in the signs and symptoms of dysphagia that had a positive impact on the quality of life were observed. Furthermore, there was no relation between the patients' motor subtype and swallowing pre- and post-DBS.  There was an improvement in the quality of life of the patients after DBS. However, the improvement in the clinical signs and symptoms of dysphagia did not cause an overall improvement in the swallowing function.

摘要

深部脑刺激(DBS)是帕金森病(PD)的一种既定治疗方法。然而,关于DBS对吞咽困难影响的证据很少。

为了评估DBS手术前后帕金森病患者的吞咽情况和生活质量。

我们的样本由在巴西南里奥格兰德州一家转诊医院接受过DBS手术的患者组成。纳入标准为帕金森病诊断且接受过DBS手术。通过一份关于抑郁和生活质量的问卷进行了认知筛查。在手术前后对每位患者的吞咽情况进行了评估。评估包括问诊、临床评估、功能性口服摄入量量表、吞咽临床评估以及Hoehn和Yahr量表。

样本包括10名男性,平均年龄57.3岁(±4.7),平均病程13.0年(±2.4),平均受教育年限8.1年(±4.0)。在吞咽的临床评估中,未观察到DBS术后有显著改善。然而,观察到吞咽困难的体征和症状有轻微变化,这对生活质量有积极影响。此外,患者的运动亚型与DBS术前和术后的吞咽情况之间没有关联。

DBS术后患者的生活质量有所改善。然而,吞咽困难临床体征和症状的改善并未导致吞咽功能的整体改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff73/5882365/cf1a78dcc5ce/10-1055-s-0037-1603466-i0572-1.jpg

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