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帕金森病患者接受脑深部电刺激手术后感知到的社会支持下降。

Perceived social support declines after deep brain stimulation surgery in patients with Parkinson's disease.

机构信息

Department of Neurology, University of Michigan, Ann Arbor, MI, USA.

Surgical Therapies Improving Movement Program, Ann Arbor, MI, USA.

出版信息

J Neural Transm (Vienna). 2022 Dec;129(12):1463-1468. doi: 10.1007/s00702-022-02558-6. Epub 2022 Oct 28.

Abstract

INTRODUCTION

The Social Provisions Scale (SPS) measures a person's perceived social support. We evaluated the perceived social support in Parkinson's disease (PD) patients before and after subthalamic nucleus (STN) deep brain stimulation (DBS) and its impact on clinical outcomes following DBS.

METHODS

We analyzed 55 PD patients who underwent STN DBS surgery and completed the SPS, PDQ-39, and MDS-UPDRS Parts I-IV before and 6-12 months after surgery. Some patients also completed global cognitive, mood and apathy scales. Caregivers completed the CBI at each visit. Linear regression models and linear mixed models evaluated the association between the SPS baseline score, MDS-UPDRS and PDQ-39 scores, the association between MDS-UPDRS, CBI and the SPS follow-up score, and the association between SPS, global cognition and other psychological variables.

RESULTS

DBS implantation improved MDS-UPDRS I-IV and PDQ-39 scores. Perceived social support declined after DBS (baseline SPS total 82.55 ± 7.52 vs. follow-up SPS total 78.83 ± 9.02, p = 0.0001). Baseline SPS total score was not significantly associated with the MDS-UPDRS or PDQ-39 scores at follow-up. MDS-UPDRS scores and the CBI at follow-up had no significant association with SPS total score at follow-up. Measures of global cognition, mood and apathy were associated with the SPS before and after DBS, and the association was independent of STN DBS.

CONCLUSION

After STN DBS, PD patients experienced a decrease in perceived social support, but baseline perceived social support did not impact clinical outcomes. It is important to further identify factors that may contribute to this perception of worsened social support.

摘要

简介

社会规定量表(SPS)衡量一个人感知到的社会支持。我们评估了帕金森病(PD)患者在丘脑底核(STN)深部脑刺激(DBS)前后的感知社会支持及其对 DBS 后临床结果的影响。

方法

我们分析了 55 名接受 STN DBS 手术的 PD 患者,他们在手术前和手术后 6-12 个月完成了 SPS、PDQ-39 和 MDS-UPDRS 第 I-IV 部分。一些患者还完成了整体认知、情绪和冷漠量表。在每次就诊时,护理人员都完成了 CBI。线性回归模型和线性混合模型评估了 SPS 基线评分与 MDS-UPDRS 和 PDQ-39 评分之间的关系、MDS-UPDRS、CBI 与 SPS 随访评分之间的关系以及 SPS、整体认知与其他心理变量之间的关系。

结果

DBS 植入改善了 MDS-UPDRS I-IV 和 PDQ-39 评分。DBS 后感知社会支持下降(基线 SPS 总分 82.55±7.52 与随访 SPS 总分 78.83±9.02,p=0.0001)。基线 SPS 总分与随访时的 MDS-UPDRS 或 PDQ-39 评分无显著相关性。随访时的 MDS-UPDRS 评分和 CBI 与随访时的 SPS 总分无显著相关性。整体认知、情绪和冷漠的测量值与 DBS 前后的 SPS 相关,并且这种相关性独立于 STN DBS。

结论

在 STN DBS 后,PD 患者经历了感知到的社会支持下降,但基线感知社会支持并未影响临床结果。进一步确定可能导致这种社会支持恶化感知的因素很重要。

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