Mameli Francesca, Ruggiero Fabiana, Dini Michelangelo, Marceglia Sara, Prenassi Marco, Borellini Linda, Cogiamanian Filippo, Pirola Elena, Remore Luigi Gianmaria, Fiore Giorgio, Reitano Maria Rita, Maiorana Natale, Poletti Barbara, Locatelli Marco, Barbieri Sergio, Priori Alberto, Ferrucci Roberta
Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy.
"Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy.
Neuromodulation. 2023 Feb;26(2):394-402. doi: 10.1016/j.neurom.2022.01.004. Epub 2022 Feb 24.
Despite the large amount of literature examining the potential influence of subthalamic nucleus deep brain stimulation (STN-DBS) on psychiatric symptoms and cognitive disorders, only a few studies have focused on its effect on personality. We investigated the correlation between total electrical energy delivered (TEED) and the occurrence of depressive traits in patients with Parkinson disease (PD) after one year of DBS.
Our study involved 20 patients with PD (12 women, mean [±SD] age 57.60 ± 7.63 years) who underwent bilateral STN-DBS, whose personality characteristics were assessed using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), according to the core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT-PD) procedure.
We found that despite a marked improvement in motor functions and quality of life after 12 months, patients showed a significant increase in MMPI-2 subscales for depression (D scale and Depression scale) and in other content component scales (low self-esteem, work interference, and negative treatment indicators). Interestingly, only the TEED on the right side was inversely correlated with the changes in scale D (r = -0.681, p = 0.007), whereas depressive traits did not correlate with disease duration, levodopa equivalent daily dose (LEDD) reduction, patient's age, or severity of motor symptoms.
Our preliminary observations indicate that despite the excellent motor outcome and general improvement in quality of life, DBS treatment can result in patients poorly adjusting to their personal, familiar, and socio-professional life. Different influences and multiple factors (such as TEED, intra/postsurgical procedure, coping mechanisms, and outcome expectations) may affect depressive traits. Further advances are expected to improve stimulation methods.
尽管有大量文献研究丘脑底核深部脑刺激（STN-DBS）对精神症状和认知障碍的潜在影响，但只有少数研究关注其对人格的影响。我们调查了帕金森病（PD）患者在接受DBS治疗一年后，总电能量传递（TEED）与抑郁特质发生之间的相关性。
我们的研究纳入了20例接受双侧STN-DBS的PD患者（12名女性，平均[±标准差]年龄57.60±7.63岁），根据帕金森病手术介入治疗核心评估程序（CAPSIT-PD），使用明尼苏达多相人格调查表-2（MMPI-2）评估其人格特征。
我们发现，尽管12个月后运动功能和生活质量有显著改善，但患者的MMPI-2抑郁分量表（D分量表和抑郁量表）以及其他内容分量表（低自尊、工作干扰和消极治疗指标）有显著增加。有趣的是，只有右侧的TEED与D分量表的变化呈负相关（r = -0.681，p = 0.007），而抑郁特质与病程、左旋多巴等效日剂量（LEDD）降低、患者年龄或运动症状严重程度无关。
我们的初步观察表明，尽管DBS治疗在运动方面取得了良好效果且生活质量总体有所改善，但可能导致患者在个人、家庭和社会职业生活中难以适应。不同的影响因素和多种因素（如TEED、手术中/后过程、应对机制和结果预期）可能会影响抑郁特质。预计未来会改进刺激方法。
