适应性深部脑刺激对帕金森病的认知影响：稳定且无风险。
Cognitive effects of adaptive deep brain stimulation in Parkinson's disease: stability without risk.
作者信息
Ferrucci Roberta, Ruggiero Fabiana, Aiello Edoardo Nicolò, Marceglia Sara, Prenassi Marco, Poletti Barbara, Cortese Francesca, Bocci Tommaso, Mellace Denise, Arlotti Mattia, Maiorana Natale, Mameli Francesca, Borellini Linda, Cogiamanian Filippo, Mailland Enrico, Ticozzi Nicola, Vergari Maurizio, Pirola Elena, Ampollini Antonella, Remore Luigi, Locatelli Marco, Barbieri Sergio, Priori Alberto
机构信息
Dipartimento di Neuroscienze e Salute Mentale, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122, Milano, Italy.
Dipartimento di Oncologia ed Emato Oncologia, Università degli Studi di Milano, Via Santa Sofia 9/1, 20122, Milano, Italy.
出版信息
Eur J Med Res. 2025 Aug 29;30(1):820. doi: 10.1186/s40001-025-03064-7.
BACKGROUND
Adaptive deep brain stimulation (aDBS) is a closed-loop system that adjusts stimulation based on patient biomarkers. This study evaluated the cognitive safety of aDBS in Parkinson's disease (PD).
METHODS
Sixteen PD patients with bilateral subthalamic DBS underwent cognitive assessments (attention, language, memory) 6 days post-surgery during an 8 h protocol. Testing occurred at five time points: T1 (aDBS, medication "off"), T2/T4 (aDBS, medication "on"), and T3/T5 (aDBS "on", medication "off"). Four patients followed the same protocol with continuousDBS (cDBS).
RESULTS
Results showed no cognitive fluctuations in aDBS patients (p ≥ 0.110). However, cDBS patients exhibited significant reaction time (RT) variations (p = 0.019), with RTs lower at T1 than T3 (p = 0.011) and T5 (p = 0.021), and at T4 compared to T2 (p = 0.002).
CONCLUSION
These findings suggest that 8 h aDBS may not adversely affect cognitive performance, providing preliminary evidence of its cognitive safety and stability in PD.
背景
自适应深部脑刺激（aDBS）是一种基于患者生物标志物调整刺激的闭环系统。本研究评估了aDBS在帕金森病（PD）中的认知安全性。
方法
16例接受双侧丘脑底核DBS的PD患者在术后6天进行了8小时方案下的认知评估（注意力、语言、记忆）。测试在五个时间点进行：T1（aDBS开启，药物“关”）、T2/T4（aDBS开启，药物“开”）以及T3/T5（aDBS开启，药物“关”）。4例患者采用持续DBS（cDBS）遵循相同方案。
结果
结果显示aDBS患者无认知波动（p≥0.110）。然而，cDBS患者表现出显著的反应时间（RT）变化（p = 0.019），T1时的RT低于T3（p = 0.011）和T5（p = 0.021），且T4时低于T2（p = 0.002）。
结论
这些发现表明8小时的aDBS可能不会对认知表现产生不利影响，为其在PD中的认知安全性和稳定性提供了初步证据。
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