Wang Zhuohang, Zheng Zijian, Huang Junwen, Cai Xu, Liu Xinjie, Xue Cheng, Yao Longping, Lu Guohui
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
Institute for Anatomy and Cell Biology, Medical Faculty, Heidelberg University, 69120, Heidelberg, Germany.
Heliyon. 2024 Feb 10;10(4):e26303. doi: 10.1016/j.heliyon.2024.e26303. eCollection 2024 Feb 29.
Bilateral deep thalamic nucleus brain stimulation (STN-DBS) surgery is often used to treat the motor symptoms of patients with Parkinson's disease. The change of neurocognitive symptoms in patients is, however, still unclear.
We aimed at analyzing the deterioration of neurocognitive symptoms in patients with Parkinson's disease after deep brain stimulation surgery under different follow-up times.
A comprehensive literature review was conducted using Pubmed, Cochrane Library, and Web of Science to screen eligible study records, the meta-analysis was performed using an inverse variance method and a random-effects model. Additionally, the areas of analysis include five: cognition, executive function, memory capacity, and verbal fluency (phonetic fluency and semantic fluency). They were analyzed for changes at six and twelve months postoperatively compared to baseline. The Meta-analysis has been registered with PROSPERO under the registration number: CRD42022308786.
In terms of overall cognitive performance, executive function, and memory capacity, the original studies show a trend of improvement in these areas at 12 months postoperatively compared with 6 months, at variance, patients did not improve or deteriorated in phonetic fluency(d = -0.42 at both 6-month and 12-month follow-up) and semantic fluency from 6 to 12 months postoperatively.
In terms of most neurocognitive symptoms, including cognitive ability, executive function, and learning memory capacity, bilateral STN-DBS surgery appears to be safe at relatively long follow-up times. However, postoperative phonetic and semantic fluency changes should still not be underestimated, and clinicians should pay more attention to patients' changes in both.
双侧丘脑底核脑深部电刺激（STN-DBS）手术常用于治疗帕金森病患者的运动症状。然而，患者神经认知症状的变化仍不明确。
分析帕金森病患者在不同随访时间的脑深部电刺激手术后神经认知症状的恶化情况。
使用PubMed、Cochrane图书馆和Web of Science进行全面的文献综述，以筛选符合条件的研究记录，采用逆方差法和随机效应模型进行荟萃分析。此外，分析领域包括五个方面：认知、执行功能、记忆能力和语言流畅性（语音流畅性和语义流畅性）。将术后6个月和12个月时与基线相比的变化进行分析。该荟萃分析已在PROSPERO注册，注册号为：CRD42022308786。
在总体认知表现、执行功能和记忆能力方面，原始研究显示，与术后6个月相比，术后12个月这些领域有改善趋势，不同的是，患者术后6个月和12个月的语音流畅性（d = -0.42）以及术后6至12个月的语义流畅性没有改善或出现恶化。
就大多数神经认知症状而言，包括认知能力、执行功能和学习记忆能力，双侧STN-DBS手术在相对较长的随访时间内似乎是安全的。然而，术后语音和语义流畅性的变化仍不应被低估，临床医生应更多关注患者在这两方面的变化。
