Adelaide Medical School, University of Adelaide, Adelaide, Australia.
The Queen Elizabeth Hospital, Woodville, Australia.
Br J Neurosurg. 2020 Oct;34(5):587-590. doi: 10.1080/02688697.2019.1639617. Epub 2019 Jul 11.
Deep brain stimulation (DBS) is a treatment that may be suitable for patients with Parkinson's disease (PD) with severe motor fluctuations and/or dyskinesias despite optimised medical therapy. DBS has been associated with side effects including deterioration in cognition, verbal fluency and mood. Studies assessing the effect of DBS on orthostatic hypotension (OH) have produced variable results. The aim is to summarise peer-reviewed studies that have assessed the effect of DBS on systolic or diastolic BP in PD patients. The databases PubMed, EMBASE, Medline and Scopus were searched using the terms on 13 April 2017. Fourteen studies fulfilled the inclusion criteria. Ten studies involved subthalamic nucleus (STN) DBS, three studies globus pallidus interna (GPi) DBS and one study involved DBS of the pedunculopontine nuclei and motor thalamus. The majority of the studies found results indicating that DBS in PD does not worsen OH in PD. Small sample sizes and lack of blinding of outcome assessors means this result should be approached cautiously. Future research may further investigate the effect of GPi DBS on OH and should aim to address these methodological issues.
脑深部电刺激（DBS）是一种治疗方法，可能适用于经过优化药物治疗仍存在严重运动波动和/或运动障碍的帕金森病（PD）患者。DBS 与认知功能下降、语言流畅性和情绪等副作用有关。评估 DBS 对直立性低血压（OH）影响的研究结果各不相同。本研究旨在总结评估 DBS 对 PD 患者收缩压或舒张压影响的同行评议研究。使用术语“Parkinson's disease”、“Deep brain stimulation”和“Blood pressure”于 2017 年 4 月 13 日在 PubMed、EMBASE、Medline 和 Scopus 数据库中进行检索。符合纳入标准的有 14 项研究。其中 10 项研究涉及丘脑底核（STN）DBS，3 项研究涉及苍白球内侧部（GPi）DBS，1 项研究涉及脑桥被盖核和运动丘脑的 DBS。大多数研究结果表明，DBS 不会加重 PD 中的 OH。样本量小且结局评估者缺乏盲法，意味着应谨慎得出这一结果。未来的研究可能会进一步探讨 GPi DBS 对 OH 的影响，并且应致力于解决这些方法学问题。
