解读丘脑底核深部脑刺激对帕金森病神经精神波动的影响。
Deciphering the effects of STN DBS on neuropsychiatric fluctuations in Parkinson's disease.
作者信息
Muldmaa Mari, Schmitt Emmanuelle, Infante Roberto, Kistner Andrea, Fraix Valérie, Castrioto Anna, Meoni Sara, Pélissier Pierre, Debû Bettina, Moro Elena
机构信息
Grenoble Alpes University, Movement Disorders Unit, CHU of Grenoble, Grenoble Institute of Neuroscience, Grenoble, France.
Department of Neurology, North Estonia Medical Centre, Tallinn, Estonia.
出版信息
NPJ Parkinsons Dis. 2024 Oct 26;10(1):205. doi: 10.1038/s41531-024-00811-1.
The impact of subthalamic nucleus (STN) deep brain stimulation (DBS) on neuropsychiatric fluctuations in Parkinson´s disease (PD) remains unclear. The Neuropsychiatric Fluctuations Scale (NFS) can help to fill this gap, directly measuring fluctuations between the OFF- and ON-medication conditions. The NFS provides NFS-plus (hyperdopaminergic) and NFS-minus (hypodopaminergic) sub-scores. Based on these, the NFS global scores express the overall magnitude of neuropsychiatric symptoms in both the OFF- and ON-medication states. The total fluctuation score (TFS) represents the difference between ON- vs. OFF-medication NFS global scores, thus assessing fluctuations amplitude. The NFS was used to evaluate changes in neuropsychiatric fluctuations between the OFF- and ON-medication conditions before and 1-year after bilateral STN-DBS in 45 PD patients (32 males; mean age, 61.3 ± 7.2 years; PD duration, 10.2 ± 3.0 years). After surgery, the amplitude of neuropsychiatric fluctuations was significantly reduced (p < 0.001), confirming the efficacy of STN-DBS on these symptoms.
丘脑底核（STN）深部脑刺激（DBS）对帕金森病（PD）神经精神波动的影响仍不明确。神经精神波动量表（NFS）有助于填补这一空白，它能直接测量服药期和未服药期之间的波动情况。NFS提供NFS加（多巴胺能亢进）和NFS减（多巴胺能减退）两个子分数。基于这些，NFS总分表示未服药和服药状态下神经精神症状的总体严重程度。总波动分数（TFS）代表服药与未服药时NFS总分之间的差异，从而评估波动幅度。在45例PD患者（32例男性；平均年龄61.3±7.2岁；PD病程10.2±3.0年）中，使用NFS评估双侧STN-DBS术前及术后1年服药期和未服药期神经精神波动的变化。术后，神经精神波动幅度显著降低（p<0.001），证实了STN-DBS对这些症状的疗效。
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