Universidade Positivo, Curitiba PR, Brazil.
Hospital Universitário Cajuru, Curitiba PR, Brazil.
Arq Neuropsiquiatr. 2022 Apr;80(4):391-398. doi: 10.1590/0004-282X-ANP-2021-0048.
Deep brain stimulation (DBS) is a well-established procedure for treating Parkinson's disease (PD). Although its mechanisms of action are still unclear, improvements in motor symptoms and reductions in medication side effects can be achieved for a significant proportion of patients, with consequent enhancement of quality of life.
To investigate the impact of DBS on the quality of life of PD patients.
This was a retrospective longitudinal study with collection of historical data in a neurosurgery center, from June 2019 to December 2020. The sample was obtained according to convenience, and the Parkinson's Disease Questionnaire (PDQ-39), Unified Parkinson's Disease Rating Scale (UPDRS) III and IV, Trail-Making Test and Verbal Fluency Test were used.
Data were collected from 17 patients (13 with subthalamic nucleus DBS and 4 with globus pallidus pars interna DBS). Significant improvement (p=0.008) on the UPDRS III was observed in comparing the preoperative without DBS with the postoperative with DBS. About 47.0% of the patients showed post-surgical improvement in QoL (p=0.29). Thirteen patients were able to complete part A of the Trail-Making Test and four of these also completed part B. Almost 60% of the patients scored sufficiently on the semantic test, whereas only 11.8% scored sufficiently on the orthographic evaluation. No association between implant site and test performance could be traced.
Improvements in quality of life and motor function were observed in the majority of the patients enrolled. Despite the limitations of this study, DBS strongly benefits a significant proportion of PD patients when well indicated.
深部脑刺激(DBS)是一种治疗帕金森病(PD)的成熟方法。尽管其作用机制仍不清楚,但对很大一部分患者可以实现运动症状的改善和药物副作用的减少,从而提高生活质量。
探讨 DBS 对 PD 患者生活质量的影响。
这是一项回顾性纵向研究,于 2019 年 6 月至 2020 年 12 月在神经外科中心收集历史数据。根据方便原则抽取样本,使用帕金森病问卷(PDQ-39)、统一帕金森病评定量表(UPDRS)III 和 IV、连线测试和词语流畅性测试。
共收集了 17 名患者(13 名接受丘脑底核 DBS,4 名接受苍白球内侧部 DBS)的数据。与术前无 DBS 相比,术后 DBS 时 UPDRS III 显著改善(p=0.008)。约 47.0%的患者术后生活质量(QoL)改善(p=0.29)。13 名患者能够完成连线测试 A 部分,其中 4 名也完成了 B 部分。近 60%的患者语义测试得分足够,而只有 11.8%的患者在正字法评估中得分足够。未发现植入部位与测试表现之间存在关联。
大多数入组患者的生活质量和运动功能均得到改善。尽管存在研究局限性,但 DBS 在适应证明确的情况下对相当一部分 PD 患者有显著益处。