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丘脑底核和苍白球内侧部深部脑刺激治疗帕金森病的安全性:围手术期并发症和心理影响的系统评价

The safety profile of subthalamic nucleus and globus pallidus internus deep brain stimulation for Parkinson's diseases: A systematic review of perioperative complications and psychological impacts.

作者信息

Eliufoo Elihuruma, Kamuyalo Chimwemwe, Yusheng Tian, Nyundo Azan, Yamin Li

机构信息

Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China.

Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania.

出版信息

Langenbecks Arch Surg. 2025 Apr 17;410(1):131. doi: 10.1007/s00423-025-03674-z.

Abstract

BACKGROUND

Despite its widespread use and acceptance, there is still a significant need for a comprehensive understanding of the safety profile of deep brain stimulation (DBS) for Parkinson's Disease. This study investigates the surgical and psychological complications associated with DBS surgery for movement disorders, aiming to quantify patient risk and promote broader acceptance of the procedure.

METHODS

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. It focused on a substantial population of 3,599 patients from various studies who underwent DBS between 2000 and 2024. A thorough literature search was carried out to identify studies on the safety profile of DBS in Parkinson's Disease (PD) across multiple electronic databases. Two reviewers extracted data and independently assessed the risk of bias, and all authors resolved any discrepancies collectively.

RESULTS

This review identified 17,453 studies, but only 26 were thoroughly reviewed after fulfilling all inclusion criteria. DBS showed both therapeutic benefits and significant risks, with complications including neurological deficits, infections, cognitive and psychiatric symptoms, surgical or device-related issues, motor dysfunction, and mortality.

CONCLUSION

Overall, the findings support the cognitive safety of DBS, revealing limited adverse effects on cognitive functions. This review confirms therapeutic advantages and significant risks during and after surgery, including intraoperative and long-term adverse events. Additional reviews are required to evaluate the long-term impact of these complications, thereby enhancing patient safety and quality of life.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

尽管深部脑刺激(DBS)在帕金森病治疗中已被广泛应用并得到认可,但仍迫切需要全面了解其安全性。本研究调查了DBS手术治疗运动障碍相关的手术及心理并发症,旨在量化患者风险并促进该手术的更广泛接受。

方法

本系统评价按照系统评价和Meta分析的首选报告项目(PRISMA)指南进行。研究对象为2000年至2024年间接受DBS手术的来自各项研究的3599例患者。通过全面的文献检索,在多个电子数据库中识别关于帕金森病(PD)中DBS安全性的研究。两名评价者提取数据并独立评估偏倚风险,所有作者共同解决任何分歧。

结果

本评价共识别出17453项研究,但只有26项在满足所有纳入标准后进行了全面审查。DBS显示出治疗益处和显著风险,并发症包括神经功能缺损、感染、认知和精神症状、手术或器械相关问题、运动功能障碍及死亡。

结论

总体而言,研究结果支持DBS的认知安全性,显示其对认知功能的不良影响有限。本评价证实了手术期间及术后的治疗优势和显著风险,包括术中及长期不良事件。需要进一步的评价来评估这些并发症的长期影响,从而提高患者安全性和生活质量。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/531e/12006204/114afcfa2322/423_2025_3674_Fig1_HTML.jpg

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