Cavallieri Francesco, Fraternali Alessandro, Arnone Annachiara, Campanini Isabella, Marti Alessandro, Gessani Annalisa, Fioravanti Valentina, Molinari Maria Angela, Di Rauso Giulia, Antonelli Francesca, Rispoli Vittorio, Feletti Alberto, Stanzani Riccardo, Damiano Benedetta, Scaltriti Sara, Cavazzuti Lorenzo, Bardi Elisa, Corni Maria Giulia, Cavalleri Francesca, Biagini Giuseppe, Pavesi Giacomo, Lusuardi Mirco, Budriesi Carla, Merlo Andrea, Versari Annibale, Valzania Franco
Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
Nuclear Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
J Pers Med. 2024 Dec 10;14(12):1150. doi: 10.3390/jpm14121150.
Our aim was to evaluate the possible long-term cerebral deposition of amyloid-β in patients with PD treated with subthalamic nucleus deep brain stimulation (STN-DBS) and its possible influence on axial and cognitive variables. Consecutive PD patients treated with bilateral STN-DBS with a long-term follow-up were included. The amyloid-β deposition was evaluated postoperatively through an 18F-flutemetamol positron emission tomography (PET) study. Axial symptoms were assessed using a standardized clinical-instrumental approach. The speech was assessed by perceptual and acoustic analysis, while gait was assessed by means of the instrumented Timed Up and Go test (iTUG). Motor severity was evaluated by applying the UPDRS part III score and subscores, while cognitive functions were assessed through a complete neuropsychological assessment. Different stimulation and drug conditions were assessed: on-stimulation/off-medication, off-stimulation/off-medication, and on-stimulation/on-medication conditions (single- and dual-task). In total, 19 PD patients (male: 11; age: 63.52 years; on-stimulation/on-medication UPDRS-III: 17.05) with a five-year postoperative follow-up were included. The amyloid-β deposition was found in 21% of patients (4/19) with a prevalent involvement of prefrontal, limbic, and parietal areas. Compared with patients without amyloid-β deposition, PD patients with positive 18F-flutemetamol in the PET study showed a higher preoperative UPDRS-I ( = 0.037) score. Our results suggest that in the long term, after STN-DBS, a significant percentage of PD patients may present brain amyloid-β deposition. However, larger samples are needed to evaluate the possible role of amyloid-β deposition in the development of axial and cognitive alterations after surgery.
我们的目的是评估接受丘脑底核深部脑刺激（STN-DBS）治疗的帕金森病（PD）患者中β-淀粉样蛋白可能的长期脑内沉积情况，及其对轴向和认知变量的可能影响。纳入了接受双侧STN-DBS治疗且进行长期随访的连续PD患者。术后通过18F-氟替美莫正电子发射断层扫描（PET）研究评估β-淀粉样蛋白沉积情况。采用标准化的临床-仪器方法评估轴向症状。通过感知和声学分析评估言语，通过仪器化的计时起立行走测试（iTUG）评估步态。应用统一帕金森病评定量表（UPDRS）第三部分评分及子评分评估运动严重程度，通过完整的神经心理学评估评估认知功能。评估了不同的刺激和药物状态：刺激开启/停药、刺激关闭/停药以及刺激开启/服药状态（单任务和双任务）。总共纳入了19例接受术后五年随访的PD患者（男性11例；年龄63.52岁；刺激开启/服药时UPDRS-III评分为17.05）。在21%的患者（4/19）中发现了β-淀粉样蛋白沉积，主要累及前额叶、边缘叶和顶叶区域。与无β-淀粉样蛋白沉积的患者相比，PET研究中18F-氟替美莫呈阳性的PD患者术前UPDRS-I评分更高（P = 0.037）。我们的结果表明，从长期来看，STN-DBS术后相当比例的PD患者可能出现脑β-淀粉样蛋白沉积。然而，需要更大的样本量来评估β-淀粉样蛋白沉积在术后轴向和认知改变发展中的可能作用。
