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深部脑刺激与帕金森病患者认知功能的有害影响有关吗?一项系统评价。

Is Deep Brain Stimulation Associated With Detrimental Effects on Cognitive Functions in Patients of Parkinson's Disease? A Systematic Review.

作者信息

Maheshwary Ankush, Mohite Divya, Omole Janet A, Bhatti Karandeep S, Khan Safeera

机构信息

Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.

Medicine, Mrs. Khushbir Kalra's Memorial Hospital, Amritsar, IND.

出版信息

Cureus. 2020 Aug 12;12(8):e9688. doi: 10.7759/cureus.9688.

Abstract

Deep brain stimulation (DBS) is a rapidly evolving procedure with its application in multiple fields of neurology, but it is most prominent in Parkinson's disease (PD). Through electrode implantation in different areas of the brain, it brings a favorable change to the motor symptoms to the magnitude that none of the medications have been able to, but the effect on cognition of the patients is still unknown. We did a comprehensive search through PubMed and Cochrane databases and conducted a systematic review by following the PRISMA guidelines. Inclusion criteria were studies conducted only in PD patients, after the year 2008. The studies published in languages other than English were excluded. Thirteen studies, including randomized and non-randomized controlled trials, observational studies, and meta-analysis, were analyzed in detail. The results showed a declining trend in verbal fluency and attention domains of cognition, while other functions remained unchanged. The decline was significant but not enough to impact the quality index in patients. DBS is associated with worse performance in verbal fluency and attention, and there is a further need for studies focusing on these domains with long-term follow-up. The overall cognitive profile was not affected significantly.

摘要

脑深部电刺激术(DBS)是一种快速发展的治疗方法,已应用于多个神经学领域,但在帕金森病(PD)中最为突出。通过将电极植入大脑的不同区域,它给运动症状带来了药物无法达到的显著改善,但对患者认知的影响仍不明确。我们通过PubMed和Cochrane数据库进行了全面检索,并按照PRISMA指南进行了系统评价。纳入标准为2008年后仅在帕金森病患者中开展的研究。排除非英文发表的研究。对13项研究进行了详细分析,包括随机和非随机对照试验、观察性研究以及荟萃分析。结果显示,认知的语言流畅性和注意力领域呈下降趋势,而其他功能保持不变。这种下降虽显著,但不足以影响患者的质量指标。脑深部电刺激术与语言流畅性和注意力方面的较差表现相关,进一步需要对这些领域进行长期随访研究。总体认知概况未受到显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/065e/7486084/fcd9bc387d3e/cureus-0012-00000009688-i01.jpg

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