Chang Bowen, Mei Jiaming, Ni Chen, 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. 2023 Jan 28;13(2):219. doi: 10.3390/brainsci13020219.
Parkinson's disease (PD) represents one of the most frequently seen neurodegenerative disorders, while anxiety accounts for its non-motor symptom (NMS), and it has greatly affected the life quality of PD cases. Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) can effectively treat PD. This study aimed to develop a clinical prediction model for the anxiety improvement rate achieved in PD patients receiving STN-DBS.
The present work retrospectively enrolled 103 PD cases undergoing STN-DBS. Patients were followed up for 1 year after surgery to analyze the improvement in HAMA scores. Univariate and multivariate logistic regression were conducted to select factors affecting the Hamilton Anxiety Scale (HAMA) improvement. A nomogram was established to predict the likelihood of achieving anxiety improvement. Receiver operating characteristic (ROC) curve analysis, decision curve analysis (DCA), and calibration curve analysis were conducted to verify nomogram performance.
The mean improvement in HAMA score was 23.9% in 103 patients; among them, 68.9% had improved anxiety, 25.2% had worsened (Preop) anxiety, and 5.8% had no significant change in anxiety. Education years, UPDRS-III preoperative score, and HAMA preoperative score were independent risk factors for anxiety improvement. The nomogram-predicted values were consistent with real probabilities.
Collectively, a nomogram is built in the present work for predicting anxiety improvement probability in PD patients 1 year after STN-DBS. The model is valuable for determining expected anxiety improvement in PD patients undergoing STN-DBS.
帕金森病（PD）是最常见的神经退行性疾病之一，而焦虑是其非运动症状（NMS），严重影响了帕金森病患者的生活质量。双侧丘脑底核深部脑刺激（STN-DBS）可有效治疗帕金森病。本研究旨在建立一种临床预测模型，用于预测接受STN-DBS治疗的帕金森病患者的焦虑改善率。
本研究回顾性纳入了103例接受STN-DBS治疗的帕金森病患者。术后对患者进行1年随访，分析汉密尔顿焦虑量表（HAMA）评分的改善情况。采用单因素和多因素逻辑回归分析筛选影响HAMA评分改善的因素。建立列线图以预测焦虑改善的可能性。采用受试者工作特征（ROC）曲线分析、决策曲线分析（DCA）和校准曲线分析来验证列线图的性能。
103例患者HAMA评分的平均改善率为23.9%；其中，68.9%的患者焦虑症状改善，25.2%的患者焦虑症状加重（术前），5.8%的患者焦虑症状无明显变化。受教育年限、术前统一帕金森病评定量表第三部分（UPDRS-III）评分和术前HAMA评分是焦虑改善的独立危险因素。列线图预测值与实际概率一致。
本研究建立了一种列线图，用于预测帕金森病患者接受STN-DBS治疗1年后的焦虑改善概率。该模型对于确定接受STN-DBS治疗的帕金森病患者的预期焦虑改善情况具有重要价值。
