Busteed Laura, García-Sánchez Carmen, Pascual-Sedano Berta, Grunden Nicholas, Gironell Alexandre, Kulisevsky Jaime, Pagonabarraga Javier
Department of Medicine, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain.
Movement Disorders Unit, Neurology Department, Santa Creu i Sant Pau Hospital, Barcelona, Spain.
Arch Clin Neuropsychol. 2025 Jan 21;40(1):22-32. doi: 10.1093/arclin/acae062.
The effects of stimulation frequency on verbal fluency (VF) following subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) are not well understood. The present study examines the impact stimulation frequency has on VF following bilateral STN-DBS in PD.
Prospective study of 38 consecutive patients with PD with low frequency STN-DBS (LFS) (n = 10) and high frequency STN-DBS (HFS) (n = 14), and a non-operated PD control group consisting of patients with fluctuating response to dopaminergic medication (n = 14) homogeneous in age, education, disease duration, and global cognitive function. Patients were evaluated on VF tasks (letter, semantic, action verbs, alternating). A one-way analysis of variance (ANOVA) was conducted to assess distinctions between groups. Pre- and post-surgical comparisons of fluencies were performed for operated groups. A mixed ANOVA was applied to the data to evaluate the interaction between treatment (HFS vs. LFS) and time (pre- vs. post-surgery). Strategy use (clustering and switching) was evaluated.
Semantic and letter fluency performance revealed significant differences between HFS and LFS groups. Pre- and post-surgical comparisons revealed HFS negatively affected letter, semantic, and action fluencies, but LFS had no effect on VF. No interaction effect or main effect of treatment was found. Main effect of time was significant for semantic and action fluencies indicating a decrease in postoperative fluency performance. Patients with LFS produced larger average cluster sizes than patients with HFS.
LFS may be less detrimental to VF, but these findings suggest that VF decline following STN-DBS is not caused by stimulation frequency alone.
帕金森病（PD）患者丘脑底核深部脑刺激（STN-DBS）后刺激频率对言语流畅性（VF）的影响尚未完全明确。本研究探讨双侧STN-DBS后刺激频率对PD患者VF的影响。
对38例连续的PD患者进行前瞻性研究，其中低频STN-DBS（LFS）组（n = 10）和高频STN-DBS（HFS）组（n = 14），以及一个未手术的PD对照组，该对照组由对多巴胺能药物反应波动的患者组成（n = 14），在年龄、教育程度、病程和整体认知功能方面具有同质性。对患者进行VF任务（字母、语义、动作动词、交替）评估。进行单因素方差分析（ANOVA）以评估组间差异。对手术组进行手术前后流畅性比较。应用混合ANOVA分析数据，以评估治疗（HFS与LFS）和时间（术前与术后）之间的相互作用。评估策略使用（聚类和转换）情况。
语义和字母流畅性表现显示HFS组和LFS组之间存在显著差异。手术前后比较显示，HFS对字母、语义和动作流畅性有负面影响，但LFS对VF没有影响。未发现治疗的交互作用或主效应。时间的主效应在语义和动作流畅性方面显著，表明术后流畅性表现下降。LFS患者产生的平均聚类大小比HFS患者大。
LFS对VF的损害可能较小，但这些发现表明STN-DBS后VF下降并非仅由刺激频率引起。
