Cozac Vitalii V, Schwarz Nadine, Bousleiman Habib, Chaturvedi Menorca, Ehrensperger Michael M, Gschwandtner Ute, Hatz Florian, Meyer Antonia, Monsch Andreas U, Taub Ethan, Fuhr Peter
Department of Neurology Hospital of the University of Basel Basel Switzerland.
Swiss Tropical and Public Health Institute University of Basel Basel Switzerland.
Mov Disord Clin Pract. 2015 Sep 16;3(1):48-52. doi: 10.1002/mdc3.12231. eCollection 2016 Jan-Feb.
DBS is commonly used to treat Parkinson's disease (PD). DBS is not considered to cause major cognitive side effects, but some research groups have reported that it can cause decreased verbal fluency. The influence of age on DBS cognitive outcome is unclear. We investigated the possible influence of patients' age, level of education, disease duration, disease progression, depression, and levodopa equivalent dose (LED) on verbal fluency performance in patients with PD who underwent DBS of the subthalamic nucleus (STN-DBS). In this article, we investigated the influence of demographic and clinical parameters, especially age, on cognitive performance post-DBS in PD patients.
Forty-three patients with PD and without major psychiatric illness (according to Diagnostic and Statistical Manual of Mental Disroders, Fourth Edition) were enrolled in the study. Median age was 64.0 years (range, 46-77). In 21 patients, the indication for DBS was established on clinical grounds in keeping with international guidelines; these patients underwent STN-DBS, and the remaining 22 did not. Cognitive performance in both groups was assessed by standard neuropsychological test batteries at baseline and after median follow-up of 7 months.
A statistically significant decline in the semantic category of verbal fluency task was found in the STN-DBS group ( < 0.01). Linear regression model revealed an influence of age ( < 0.01) and disease duration ( < 0.01) in relation to this decline.
This study confirms previous findings that verbal fluency declines after STN-DBS in PD patients in comparison to PD patients without DBS. This decline is related to age and disease duration.
脑深部电刺激术（DBS）常用于治疗帕金森病（PD）。DBS一般不被认为会引起严重的认知副作用，但一些研究小组报告称其可导致言语流畅性下降。年龄对DBS认知结果的影响尚不清楚。我们研究了患者的年龄、教育程度、病程、疾病进展、抑郁程度以及左旋多巴等效剂量（LED）对接受丘脑底核脑深部电刺激术（STN-DBS）的PD患者言语流畅性表现的可能影响。在本文中，我们研究了人口统计学和临床参数，尤其是年龄，对PD患者DBS术后认知表现的影响。
43例无重大精神疾病（根据《精神疾病诊断与统计手册》第四版）的PD患者纳入本研究。年龄中位数为64.0岁（范围46 - 77岁）。21例患者根据国际指南基于临床情况确定为DBS适应证；这些患者接受了STN-DBS，其余22例未接受。两组患者在基线时和中位随访7个月后均通过标准神经心理测试电池评估认知表现。
STN-DBS组言语流畅性任务的语义类别出现统计学显著下降（<0.01）。线性回归模型显示年龄（<0.01）和病程（<0.01）与这种下降有关。
本研究证实了先前的发现，即与未接受DBS的PD患者相比，接受STN-DBS的PD患者术后言语流畅性下降。这种下降与年龄和病程有关。
