脑深部电刺激手术前后冷漠与认知症状的比较

Comparison of Apathy and Cognitive Symptoms in Pre- and Postoperative Period in Deep Brain Stimulation Surgery.

作者信息

Polat Selim, Erdem Miray, Çekinmez Melih

机构信息

Department of Mental Health and Diseases, Adana City Training and Research Hospital, Adana, Turkey.

Department of Neurology, Adana City Training and Research Hospital, Adana, Turkey.

出版信息

Psychiatry Clin Psychopharmacol. 2023 Dec 1;33(4):238-245. doi: 10.5152/pcp.2023.23621. eCollection 2023 Dec.

DOI:10.5152/pcp.2023.23621

PMID:38765847

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11037465/

Abstract

BACKGROUND

The aim of the study was to investigatie apathy and cognitive functions in Parkinson's disease patients who underwent deep brain stimulation surgery on bilateral subthalamic nuclei.

METHODS

This study included 18 patients with Parkinson's disease who were accommodated in the Parkinson's and Movement Disorders Center of Adana City Training and Research Hospital for treatment in 2022. Patients were evaluated by psychiatry, neurology and neurosurgery specialists with a multidisciplinary approach and found to be surgically appropriate. Standardized Mini-Mental Test and Montreal Cognitive Assessment Scale, Apathy Evaluation Scale, and Hamilton Anxiety and Depression Scale were administered to each patient before the operation and at 6 months after effective stimulation parameters were reached.

RESULTS

The mean apathy score at the preoperative zeroth month was 47.77 ± 15.83 in patients having deep brain stimulation surgery and 30.83 ± 13.59 in the postoperative sixth month. Statistically that reduction was significant ( = .003) and showed clinical development. The average Hamilton Anxiety Scale scores at the preoperative zeroth month was 11.50 ± 5.14 and 10.22 ± 5.57 at the postoperative sixth month, with no clinical significance ( = .280). The determined value for the Unified Parkinson's Disease Rating Scale, on treatment, was 22.55 ± 7.53 in the preoperative zeroth month and 14.50 ± 6.99 in the postoperative sixth month, with statistical significance (). The Unified Parkinson's Disease Rating Scale, off treatment, score was revealed to be significant in the preoperative zeroth month (37.44 ± 9.85) in comparison to that of the postoperative sixth month (23.44 ± 7.86; < .001).

CONCLUSION

This study showed that bilateral subthalamic stimulation improves nonmotor and motor symptoms in patients having Parkinson's disease. The mechanism is complex, and we believe that future studies focusing on pharmacological and nonpharmacological treatments involving more patient groups will be useful for clinicians.

摘要

背景

本研究旨在调查接受双侧丘脑底核深部脑刺激手术的帕金森病患者的冷漠情绪和认知功能。

方法

本研究纳入了2022年在阿达纳市培训与研究医院帕金森病及运动障碍中心接受治疗的18例帕金森病患者。患者由精神科、神经科和神经外科专家采用多学科方法进行评估，结果显示其适合进行手术。在手术前以及达到有效刺激参数后的6个月，对每位患者进行标准化简易精神状态检查、蒙特利尔认知评估量表、冷漠评估量表以及汉密尔顿焦虑和抑郁量表评估。

结果

接受深部脑刺激手术的患者在术前第0个月的平均冷漠评分为47.77±15.83，术后第6个月为30.83±13.59。从统计学角度来看，这种降低具有显著性（P = .003），且显示出临床改善。术前第0个月的平均汉密尔顿焦虑量表评分为11.50±5.14，术后第6个月为10.22±5.57，无临床显著性差异（P = .280）。治疗时，统一帕金森病评定量表在术前第0个月的测定值为22.55±7.53，术后第6个月为14.50±6.99，具有统计学显著性（P值未给出）。与术后第6个月（23.44±7.86；P < .001）相比，术前第0个月未进行治疗时的统一帕金森病评定量表评分具有显著性差异（37.44±9.85）。