丘脑底核脑深部电刺激对帕金森病认知功能影响  被引量:1

Influence of deep brain stimulation of subthalamic nucleus on cognitive function in patients with Parkinson′s disease

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作  者:沈博[1] 尤志菲 王晓平[1] 

机构地区:[1]上海交通大学附属第一人民医院神经内科,上海200080

出  处:《诊断学理论与实践》2016年第2期128-132,共5页Journal of Diagnostics Concepts & Practice

基  金:国家自然科学基金面上项目(81071065)

摘  要:目的 :评估丘脑底核(subthalamic nucleus,STN)脑深部电刺激术(deep brain stimulation,DBS)对帕金森病(Parkinson's disease,PD)患者认知功能的影响,并探讨其潜在的发生机制。方法 :40例PD患者中,20例PD接受双侧STN-DBS治疗(DBS组);另20例因拒绝手术,采用最佳药物进行治疗(药物治疗组),设20例健康者作为对照(对照组)。采用神经心理学方法对STN-DBS前1周、术后1年及药物治疗患者随访1年前、后的认知功能进行评估,并与20例匹配的健康对照者进行比较。结果:STN-DBS术后患者运动症状明显改善,但执行错误率明显升高(P<0.05),言语流畅性明显下降(P<0.05)。结论:STN-DBS可引起PD患者执行功能及言语流畅性的下降,但对于术前无严重认知功能障碍的患者,STN-DBS术后短期内引起的认知改变并不影响其生活质量。Objective To evaluate the effect of deep brain stimulation (DBS) of subthalamic nucleus (STN) on cognitive function in patients with Parkinson's disease (PD), and to investigate the potential mechanism. Methods: Twenty PD patients undergone STN-DBS and 20 medicine-managed PD patients were enrolled, and 20 healthy volunteers were served as controls.A comprehensive neuropsyehological battery tests and Unified Parkinson's Disease Rating Scale were performed in STN-DBS group one week before and 1 year after STN-DBS, and in medicine-managed group performed at baseline and after one year of treatment, and performed once in 20 healthy people. Results: Significant improvement in motor symptoms and decline of levodopa equivalent dose (LED) after STN-DBS was observed. In STN-DBS group, the postoperative increase of error rates and decline of verbal fluency (VF) were more significant than in medicine-managed PD patients (P〈0.05). Conclusions: While improves obviously the motor symptoms in PD patients, STN-DBS has negative effects on cognitive function, patients will experience a decrease in verbal fluency and executive function. As no global cognitive deterioration was seen in carefully selected patients, it seems to be safe for patients without severe cognitive dysfunction in short term.

关 键 词:帕金森病 脑深部电刺激 丘脑底核 认知功能 药物治疗 

分 类 号:R742.5[医药卫生—神经病学与精神病学]

 

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