Qin Guofan, Xie Hutao, Shi Lin, Zhao Baotian, Gan Yifei, Yin Zixiao, Xu Yichen, Zhang Xin, Chen Yaojing, Jiang Yin, Zhang Quan, Zhang Jianguo
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Neurostimulation, Beijing, China.
Front Neurosci. 2023 Aug 30;17:1228711. doi: 10.3389/fnins.2023.1228711. eCollection 2023.
Postural instability/gait disturbance (PIGD) is very common in advanced Parkinson's disease, and associated with cognitive dysfunction. Research suggests that low frequency (5-12 Hz) subthalamic nucleus-deep brain stimulation (STN-DBS) could improve cognition in patients with Parkinson's disease (PD). However, the clinical effectiveness of low frequency stimulation in PIGD patients has not been explored. This study was designed in a double-blinded randomized cross-over manner, aimed to verify the effect of low frequency STN-DBS on cognition of PIGD patients. Twenty-nine PIGD patients with STN-DBS were tested for cognitive at off (no stimulation), low frequency (5 Hz), and high frequency (130 Hz) stimulation. Neuropsychological tests included the Stroop Color-Word Test (SCWT), Verbal fluency test, Symbol Digital Switch Test, Digital Span Test, and Benton Judgment of Line Orientation test. For conflict resolution of executive function, low frequency stimulation significantly decreased the completion time of SCWT-C ( = 0.001) and Stroop interference effect ( < 0.001) compared to high frequency stimulation. However, no significant differences among stimulation states were found for other cognitive tests. Here we show, low frequency STN-DBS improved conflict resolution of executive function compared to high frequency. Our results demonstrated the possibility of expanding the treatment coverage of DBS to cognitive function in PIGD, which will facilitate integration of low frequency stimulation into future DBS programming.
姿势不稳/步态障碍（PIGD）在晚期帕金森病中非常常见，且与认知功能障碍相关。研究表明，低频（5 - 12赫兹）丘脑底核-脑深部电刺激（STN-DBS）可改善帕金森病（PD）患者的认知。然而，低频刺激对PIGD患者的临床有效性尚未得到探索。本研究采用双盲随机交叉设计，旨在验证低频STN-DBS对PIGD患者认知的影响。对29例接受STN-DBS治疗的PIGD患者在关期（无刺激）、低频（5赫兹）和高频（130赫兹）刺激下进行认知测试。神经心理学测试包括斯特鲁普颜色-文字测试（SCWT）、语言流畅性测试、符号数字转换测试、数字广度测试和本顿直线定向判断测试。对于执行功能的冲突解决，与高频刺激相比，低频刺激显著缩短了SCWT-C的完成时间（P = 0.001）和斯特鲁普干扰效应（P < 0.001）。然而，在其他认知测试中，各刺激状态之间未发现显著差异。在此我们表明，与高频刺激相比，低频STN-DBS改善了执行功能的冲突解决。我们的结果证明了将DBS的治疗范围扩展到PIGD认知功能的可能性，这将有助于将低频刺激纳入未来的DBS程控。
