Service de Neurologie, Hôpital Central, CHRU Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54001, Nancy Cedex, France.
Département de Neurochirurgie, Hôpital Central, CHRU de Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54001, Nancy Cedex, France.
J Neural Transm (Vienna). 2023 May;130(5):647-654. doi: 10.1007/s00702-023-02629-2. Epub 2023 Apr 6.
Parkinson's disease (PD) is a neurodegenerative disease, that combines motor and non-motor disorders, and alters patients' autonomy. Even if subthalamic nucleus deep brain stimulation (STN-DBS) induces undisputable motor improvement, a post-operative social maladjustment was described by some patients. Our aim was to describe pre-operative illness perceptions in parkinsonian patients, and to determine the possible impact of cognitive restructuration over them. We analyzed 27 parkinsonian patient's candidates to DBS. The mean age was 59 ± 5.94 years, and mean disease duration was 9.89 ± 4.15 years. The patients had two pre-operative psychological interviews (DBS-45 days, DBS-25 days) and completed the Illness Perception Questionnaire-Revised (IPQ-R) before the first interview and at DBS-1 day. The CRTG group (n = 13) had cognitive restructuration during second interview, on dysfunctional cognitions about their perception of post-DBS life which emerged from the first interview. The PIG group (n = 14) benefited of two non-structured interviews. No significant differences were found between the visits (DBS-45 days, DBS-1 day) for IPQ-R dimensions, except for the perception of "personal control" over PD which appears significantly higher for CRTG than PIG group (p = .039) at DBS-1 day, whereas the scores were quite similar at DBS-45 days. Illness perceptions seem to be stable over time and mostly influenced by disease experience of PD. However, the perception of personal control over PD seemed to be modulated through cognitive restructuration, giving patients' control back over disease. Before DBS, illness perceptions investigation and restructuration constitute an interesting point to work on, to enhance perceived benefits of neurosurgery.Trial registration: Clinical Research Program, N°IDRCB 2008-A00655-50, approved by the local ethics committee (CPP EST III, N° CPP: 08.07.03, first version date: 04/01/2008), registered on the ClinicalTrials.gov website (NCT02893449).
帕金森病（PD）是一种神经退行性疾病，它结合了运动和非运动障碍，并改变了患者的自主性。尽管丘脑底核深部脑刺激（STN-DBS）诱导了无可争议的运动改善，但一些患者描述了术后社会适应不良。我们的目的是描述帕金森病患者的术前疾病认知，并确定认知重构对其的可能影响。我们分析了 27 名接受 DBS 治疗的帕金森病患者候选人。平均年龄为 59±5.94 岁，平均病程为 9.89±4.15 年。患者在术前接受了两次心理访谈（DBS-45 天，DBS-25 天），并在第一次访谈前和 DBS-1 天完成了修订后的疾病认知问卷（IPQ-R）。CRTG 组（n=13）在第二次访谈期间进行了认知重构，针对第一次访谈中出现的对 DBS 后生活感知的功能失调认知。PIG 组（n=14）接受了两次非结构化访谈。除了 PD 个人控制感维度外，在两次访谈（DBS-45 天，DBS-1 天）之间未发现 IPQ-R 维度存在显著差异，CRTG 组的得分明显高于 PIG 组（p=0.039），而在 DBS-45 天，得分相当相似。疾病认知似乎随着时间的推移而保持稳定，主要受 PD 疾病经历的影响。然而，对 PD 个人控制的感知似乎通过认知重构得到了调节，使患者重新控制了疾病。在 DBS 之前，疾病认知调查和重构构成了一个有趣的研究点，可以增强神经外科治疗的感知益处。试验注册：临床研究计划，N°IDRCB 2008-A00655-50，经当地伦理委员会批准（CPP EST III，N°CPP：08.07.03，第一版日期：04/01/2008），在 ClinicalTrials.gov 网站上注册（NCT02893449）。
