丘脑底核脑深部电刺激术对Meige综合征患者焦虑和抑郁的影响  

Effects of subthalamic nucleus deep brain stimulation on anxiety and depression in patients with Meige syndrome

作　　者：孙明贤 孟大伟 王宁 付宗荟 喻小念 王林 SUN Mingxian;MENG Dawei;WANG Ning;FU Zonghui;YU Xiaonian;WANG Lin(不详;Department of Functional Neurosurgery,Aviation General Hospital,Beijing 100012,China)

机构地区：[1]山东第二医科大学临床医学院、山东第二医科大学,261000 [2]航空总医院功能神经外科,100012 [3]航空总医院心身医学科,100012

出　　处：《中国神经免疫学和神经病学杂志》2024年第3期198-203,共6页Chinese Journal of Neuroimmunology and Neurology

基　　金：国家重点研发计划项目(2016YFC0105900)。

摘　　要：目的观察丘脑底核(subthalamic nucleus,STN)脑深部电刺激术(deep brain stimulation,DBS)对Meige综合征(Meige syndrome)患者焦虑、抑郁的影响。方法回顾性纳入2016年4月至2022年1月航空总医院行STN-DBS治疗的25例Meige综合征患者,比较患者术前与术后≥1年的汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分、汉密顿抑郁量表(Hamilton depression scale,HAMD)评分和Burke-Fahn-Marsden肌张力障碍运动评分量表(Burke-Fahn-Marsden dystonia rating scale,BFMDRS)评分的差异;采用Spearman相关性分析焦虑、抑郁改善程度与BFMDRS改善程度、运动障碍改善程度、功能障碍改善程度的相关性。结果Meige综合征患者STN-DBS治疗≥1年时其HAMA评分、HAMD评分和BFMDRS评分均较治疗前下降(均P<0.01),HAMA、HAMD及BFMDRS改善率中位数(四分位数)分别为63%(25%,77%)、67%(30%,80%)、79%(55%,86%);HAMA评分改善率与BFMDRS评分改善率和运动障碍评分改善率呈正相关(r=0.511,P=0.009;r=0.407,P=0.043),与患者的功能障碍评分改善率无相关性(P>0.05),HAMD评分改善率与BFMDRS评分改善率和运动障碍评分改善率、功能障碍评分改善率均无相关性(均P>0.05)。结论STN-DBS能明显改善Meige综合征患者焦虑、抑郁水平,且焦虑症状改善与运动症状改善相关。Objective To explore the effect of subthalamic nucleus(STN)deep brain stimulation(DBS)on anxiety and depression in patients with Meige syndrome.Methods A total of 25 patients with Meige syndrome who were treated with STN-DBS in General Aviation Hospital from April 2016 to January 2022 were retrospectively included.The scores of Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)and Burke-Fahn-Marsden dystonia rating scale(BFMDRS)before and≥1 year after operation were compared.Spearman rank correlation was used to analyze the correlation between the degree of improvement of anxiety and depression and the degree of improvement of BFMDRS,dyskinesia and dysfunction.Results The HAMA score,HAMD score and BFMDRS score of patients with Meige syndrome treated with STN-DBS for more than one year were all lower than those before treatment(all P<0.01),the median(quartile)improvement rates of HAMA,HAMD and BFMDRS were 63%(25%,77%),67%(30%,80%)and 79%(55%,86%).The improvement rate of HAMA score was positively correlated with the improvement rate of BFMDRS score and dyskinesia score(r=0.511,P=0.009;r=0.407,P=0.043),but not correlated with the improvement rate of dysfunction score(P>0.05).There was no correlation between the improvement rate of HAMD score and the improvement rate of BFMDRS score,dyskinesia score and dysfunction score(all P>0.05).Conclusions STN-DBS can significantly improve the levels of anxiety and depression in patients with Meige syndrome,and the improvement in anxiety is related to the improvement in motor symptoms.

关 键 词：脑深部电刺激术 丘脑底核 MEIGE综合征 焦虑 抑郁 

分 类 号：R651.1[医药卫生—外科学] R742[医药卫生—临床医学]