Department of Neurology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
Department of Neurology, Shanghai TongRen Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
CNS Neurosci Ther. 2020 Sep;26(9):972-980. doi: 10.1111/cns.13392. Epub 2020 May 21.
OBJECTIVE: To evaluate the cognitive function of Chinese patients with Parkinson's disease PD postsubthalamic nucleus deep brain stimulation (STN-DBS). METHODS: Cognitive function was assessed by neuropsychological methods in PD patients. Twenty matched healthy persons served as normal controls. t test, analysis of variance, and chi-square analysis were used to compare the difference among the groups. Reliable change index was utilized to analyze the changes in cognition from the individual level. RESULTS: (a) Improvement in motor function was significantly better after STN-DBS (P < .01). (b) Notably, the increase error rates of implicit SRTT (serial reaction time task) was significantly higher after STN-DBS as compared with the conservative therapy group (P = .03). (c) The decline of verbal fluency (explicit) was also significantly higher after STN-DBS than that in the medication therapy group (P = .03). (d) In the explicit clock-drawing test, scores had significantly improved after STN-DBS (P = .04). CONCLUSIONS: STN-DBS as a neuromodulatory tool in the Chinese PD population not only improves motor symptoms but also cognitive function to a certain extent, such as the decline of executive function and verbal fluency. The explicit cognitive decline was significantly quicker than that in patients on medication therapy. The improvement of visiospatial function was also noted. Implicit memory impairment during the 1-year follow-up period was not observed.
目的:评估中国帕金森病(PD)患者丘脑底核深部脑刺激(STN-DBS)术后的认知功能。
方法:采用神经心理学方法对 PD 患者的认知功能进行评估。20 名匹配的健康人作为正常对照组。采用 t 检验、方差分析和卡方检验比较组间差异。采用可靠变化指数分析个体认知变化。
结果:(a)STN-DBS 后运动功能的改善明显更好(P<.01)。(b)值得注意的是,与保守治疗组相比,STN-DBS 后内隐 SRTT(序列反应时任务)的错误率明显增加(P=.03)。(c)STN-DBS 后言语流畅性(外显)的下降也明显高于药物治疗组(P=.03)。(d)在显性时钟绘图测试中,STN-DBS 后评分明显提高(P=.04)。
结论:STN-DBS 作为中国 PD 人群的神经调节工具,不仅改善运动症状,而且在一定程度上改善认知功能,如执行功能和言语流畅性下降。显性认知下降明显快于药物治疗组。也注意到视空间功能的改善。在 1 年的随访期间未观察到内隐记忆损伤。
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