Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás, Goiânia, GO, Brazil.
Einstein (Sao Paulo). 2024 Jul 19;22:eRW0182. doi: 10.31744/einstein_journal/2024RW0182. eCollection 2024.
To evaluate the psychiatric alterations resulting from deep brain stimulation of the subthalamic nucleus in the management of Parkinson's disease.
Articles were searched using three databases: Public/Publisher MEDLINE, Virtual Health Library, and Cochrane Library.
Eleven studies were included in the analysis. Manic syndrome alone was reported in two of the 11 studies analyzed. Psychosis alone was not reported in any of them, but it was found in association with other psychiatric alterations in two studies, not including manic syndrome. In one case report, hypersexuality was associated with depression and self-alienation. Depressive disorder was the most frequent psychiatric disorder after deep brain stimulation of the subthalamic nucleus, according to five of the reviewed articles, encompassing 26 patients. In four of these articles, depression was associated with other psychiatric disorders, such as psychosis, suicidal ideation, hypersexuality, and anxiety. Hypomanic syndrome was reported in two cases.
More common psychiatric disorders related to the neuroanatomy of the nucleus were observed, probably because of the microlesions caused by the implantation of deep brain stimulation and the regulation of the stimulation of the device. The most common disorders include depression, mania/hypomania, psychosis, anxiety, suicidal ideation, and hypersexuality.
评估丘脑底核深部脑刺激治疗帕金森病引起的精神改变。
使用三个数据库（公共/出版商 MEDLINE、虚拟健康图书馆和 Cochrane 图书馆）搜索文章。
分析中纳入了 11 项研究。在分析的 11 项研究中，仅有两项报告了单纯的躁狂综合征。任何一项研究均未报告单纯的精神病，但在两项研究中与其他精神改变相关，不包括躁狂综合征。在一份病例报告中，性欲亢进与抑郁和自我疏远有关。根据五篇综述文章，包括 26 名患者，丘脑底核深部脑刺激后最常见的精神障碍是抑郁障碍。在其中四篇文章中，抑郁与其他精神障碍相关，如精神病、自杀意念、性欲亢进和焦虑。有两例报告出现轻躁狂综合征。
观察到与核神经解剖学相关的更常见的精神障碍，可能是由于深部脑刺激的植入微损伤和设备刺激的调节所致。最常见的障碍包括抑郁、躁狂/轻躁狂、精神病、焦虑、自杀意念和性欲亢进。
