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深部脑刺激对帕金森病嗅觉功能和临床评分的治疗效果。

The therapeutic effect of deep brain stimulation on olfactory functions and clinical scores in Parkinson's disease.

机构信息

Istanbul Sancaktepe, Education and Research Hospital, Department of Otorhinolaryngology, Istanbul, Turkey.

Istanbul Medipol University, Department of Neurology, Istanbul, Turkey.

出版信息

J Clin Neurosci. 2019 Oct;68:55-61. doi: 10.1016/j.jocn.2019.07.055. Epub 2019 Aug 2.

DOI:10.1016/j.jocn.2019.07.055
PMID:31383472
Abstract

Deep brain stimulation (DBS) is still a highly effective treatment option that significantly improves motor function in advanced PD. Moreover, previous findings have shown that Olfactory dysfunction (OD) has been found in a majority of patients with Parkinson's Disease (PD). Despite this, the effect of DBS on the olfactory function is not fully understood. Here we aimed to determine the effect of STN DBS on OD by evaluating the olfactory functions in the preoperative and postoperative early stages (1st and 3rd months) in forty-five PD patients and 40 healthy controls. The therapeutic effect of DBS on the improvement of motor functions was parallelly investigated. We have observed that there was a significant improvement in OI in the 1st month and in all olfactory parameters (OT, ODI, OI, and TDI) in the 3rd month. In evaluating the motor functional scores, we have revealed a statistically significant (p < 0.001) difference between preoperative UPDRS-motor score (23 ± 7.3) and the postoperative 3rd month score (11.1 ± 5.1). Although Beck Depression and Anxiety scores were improved to a certain level in the 3rd month, this improvement was not at a statistically significant level (p > 0.05). As a conclusion, we have shown that STN-DBS improves the smell functions in PD within three months suggesting that the therapeutic effects of DBS might have a wide range of therapeutic spectrum. Despite some limitations (i.e., short follow-up period) our study gives a critical message that future studies are needed to evaluate the functional correlates of STN-DBS treatment in PD patients.

摘要

深部脑刺激(DBS)仍然是一种非常有效的治疗选择,可显著改善晚期帕金森病患者的运动功能。此外,先前的研究结果表明,大多数帕金森病(PD)患者都存在嗅觉功能障碍(OD)。尽管如此,DBS 对嗅觉功能的影响仍不完全清楚。在这里,我们旨在通过评估四十五名 PD 患者和四十名健康对照者的术前和术后早期(第 1 个月和第 3 个月)嗅觉功能,确定 STN-DBS 对 OD 的影响。同时平行研究 DBS 对改善运动功能的治疗效果。我们发现,OI 在第 1 个月有显著改善,在第 3 个月所有嗅觉参数(OT、ODI、OI 和 TDI)都有改善。在评估运动功能评分时,我们发现术前 UPDRS-运动评分(23±7.3)和术后第 3 个月评分(11.1±5.1)之间存在统计学显著差异(p<0.001)。尽管第 3 个月 Beck 抑郁和焦虑评分有所改善,但这种改善在统计学上并不显著(p>0.05)。总之,我们表明 STN-DBS 在三个月内改善了 PD 患者的嗅觉功能,这表明 DBS 的治疗效果可能具有广泛的治疗范围。尽管存在一些局限性(例如,随访时间短),但我们的研究提供了一个关键信息,即需要进行未来的研究来评估 PD 患者的 STN-DBS 治疗的功能相关性。

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