Monash University, Melbourne, Victoria, Australia.
Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada.
Qual Health Res. 2020 Dec;30(14):2217-2233. doi: 10.1177/1049732320951144. Epub 2020 Aug 28.
Deep brain stimulation (DBS) for Parkinson's disease successfully alleviates motor symptoms, but unanticipated changes in personality, self, and relationships can occur. Little is known about how these nonmotor outcomes affect patients and families. We prospectively examined the experience and meaning of DBS-related changes in personality and self for patients and caregivers. In-depth, semi-structured interviews were conducted with 22 participants (11 patient-caregiver dyads) before and 9 months after DBS and analyzed using thematic analysis. We identified three themes present prior to DBS that reflected a time of , while three themes present after DBS reflected a process of . Participants noted both positive and negative personality changes, with some, but not all, attributing them to the stimulation. The risk of stimulation-related personality change should be weighed against the procedure's motor benefits and considered in the context of disease- and medication-related personality changes. Clinical implications including perioperative education and follow-up management are discussed.
脑深部电刺激(DBS)治疗帕金森病可成功缓解运动症状,但可能会出现意想不到的人格、自我和人际关系变化。目前对于这些非运动结果如何影响患者和家属知之甚少。我们前瞻性地研究了 DBS 相关人格和自我变化对患者和护理者的体验和意义。在 DBS 之前和之后 9 个月,对 22 名参与者(11 对患者-护理员)进行了深入的半结构化访谈,并使用主题分析进行了分析。我们确定了三个在 DBS 之前存在的主题,反映了一个时期,而三个在 DBS 之后存在的主题反映了一个过程。参与者注意到了人格的积极和消极变化,有些人,但不是所有人,将这些变化归因于刺激。刺激相关人格变化的风险应权衡手术的运动益处,并结合疾病和药物相关人格变化来考虑。讨论了包括围手术期教育和后续管理在内的临床意义。