Chang Bowen, Ni Chen, Mei Jiaming, Xiong Chi, Chen Peng, Jiang Manli, Niu Chaoshi
Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China.
Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei 230001, China.
Brain Sci. 2022 Jun 28;12(7):841. doi: 10.3390/brainsci12070841.
Parkinson's disease is a common neurodegenerative disease, with depression being a common non-motor symptom. Bilateral subthalamic nucleus deep brain stimulation is an effective method for the treatment of Parkinson's disease. Thus, this study aimed to establish a nomogram of the possibility of achieving a better depression improvement rate after subthalamic nucleus deep brain stimulation in patients with Parkinson's disease.
We retrospectively analyzed 103 patients with Parkinson's disease who underwent subthalamic nucleus deep brain stimulation and were followed up for the improvement of their Hamilton Depression scale scores 1 year postoperatively. Univariate and multivariate logistic regression analyses were used to select factors affecting the improvement rate of depression. A nomogram was then developed to predict the possibility of achieving better depression improvement. Furthermore, the discrimination and fitting performance was evaluated using a calibration diagram, receiver operating characteristics, and decision curve analysis.
The mean and median improvement rates of Hamilton Depression scores were 13.1 and 33.3%, respectively. Among the 103 patients, 70.8% had an improved depression, 23.3% had a worsened depression, and 5.8% remained unchanged. Logistic multivariate regression analysis showed that age, preoperative Parkinson's Disease Questionnaire, Hamilton Anxiety, and Hamilton Depression scores were independent factors for the possibility of achieving a better depression improvement rate. Based on these results, a nomogram model was developed. The nomogram had a C-index of 0.78 (95% confidence interval: 0.69-0.87) and an area under the receiver operating characteristics of 0.78 (95% confidence interval: 0.69-0.87). The calibration plot and decision curve analysis further demonstrated goodness-of-fit between the nomogram predictions and actual observations.
We developed a nomogram to predict the possibility of achieving good depression improvement 1 year after subthalamic nucleus deep brain stimulation in patients with Parkinson's disease, which showed a certain value in judging the expected depression improvement of these patients.
帕金森病是一种常见的神经退行性疾病，抑郁是其常见的非运动症状。双侧丘脑底核深部脑刺激是治疗帕金森病的有效方法。因此，本研究旨在建立一个列线图，以预测帕金森病患者丘脑底核深部脑刺激后抑郁改善率更好的可能性。
我们回顾性分析了103例接受丘脑底核深部脑刺激的帕金森病患者，并在术后1年随访其汉密尔顿抑郁量表评分的改善情况。采用单因素和多因素逻辑回归分析来选择影响抑郁改善率的因素。然后绘制列线图以预测抑郁改善更好的可能性。此外，使用校准图、受试者操作特征曲线和决策曲线分析来评估区分度和拟合性能。
汉密尔顿抑郁评分的平均改善率和中位数改善率分别为13.1%和33.3%。在这103例患者中，70.8%的患者抑郁症状改善，23.3%的患者抑郁症状恶化，5.8%的患者保持不变。多因素逻辑回归分析显示，年龄、术前帕金森病问卷评分、汉密尔顿焦虑评分和汉密尔顿抑郁评分是抑郁改善率更好可能性的独立因素。基于这些结果，建立了一个列线图模型。该列线图的C指数为0.78（95%置信区间：0.69 - 0.87），受试者操作特征曲线下面积为0.78（95%置信区间：0.69 - 0.87）。校准图和决策曲线分析进一步证明了列线图预测与实际观察之间的拟合优度。
我们建立了一个列线图，以预测帕金森病患者丘脑底核深部脑刺激术后1年抑郁改善良好的可能性，该列线图在判断这些患者预期的抑郁改善方面显示出一定价值。
