Deciphering the effects of STN DBS on neuropsychiatric fluctuations in Parkinson’s disease

IF 6.7 1区医学 Q1 NEUROSCIENCES

NPJ Parkinson's Disease Pub Date : 2024-10-26 DOI:10.1038/s41531-024-00811-1

Mari Muldmaa, Emmanuelle Schmitt, Roberto Infante, Andrea Kistner, Valérie Fraix, Anna Castrioto, Sara Meoni, Pierre Pélissier, Bettina Debû, Elena Moro

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Abstract

The impact of subthalamic nucleus (STN) deep brain stimulation (DBS) on neuropsychiatric fluctuations in Parkinson´s disease (PD) remains unclear. The Neuropsychiatric Fluctuations Scale (NFS) can help to fill this gap, directly measuring fluctuations between the OFF- and ON-medication conditions. The NFS provides NFS-plus (hyperdopaminergic) and NFS-minus (hypodopaminergic) sub-scores. Based on these, the NFS global scores express the overall magnitude of neuropsychiatric symptoms in both the OFF- and ON-medication states. The total fluctuation score (TFS) represents the difference between ON- vs. OFF-medication NFS global scores, thus assessing fluctuations amplitude. The NFS was used to evaluate changes in neuropsychiatric fluctuations between the OFF- and ON-medication conditions before and 1-year after bilateral STN-DBS in 45 PD patients (32 males; mean age, 61.3 ± 7.2 years; PD duration, 10.2 ± 3.0 years). After surgery, the amplitude of neuropsychiatric fluctuations was significantly reduced (p < 0.001), confirming the efficacy of STN-DBS on these symptoms.

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解读 STN DBS 对帕金森病神经精神波动的影响

眼下核（STN）深部脑刺激（DBS）对帕金森病（PD）神经精神波动的影响仍不清楚。神经精神波动量表（NFS）可以帮助填补这一空白，直接测量停药和用药状态下的波动。NFS 提供 NFS-plus（多巴胺能亢进）和 NFS-minus（多巴胺能减退）两个子评分。在此基础上，NFS 总分反映了在停药和用药状态下神经精神症状的总体程度。波动总分（TFS）表示用药与停药时 NFS 总分的差异，从而评估波动幅度。我们使用 NFS 评估了 45 名帕金森病患者（32 名男性；平均年龄为 61.3 ± 7.2 岁；帕金森病病程为 10.2 ± 3.0 年）在双侧 STN-DBS 术前和术后 1 年在关药和开药状态下神经精神波动的变化。手术后，神经精神波动的幅度明显降低（p < 0.001），证实了 STN-DBS 对这些症状的疗效。

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来源期刊

NPJ Parkinson's Disease Medicine-Neurology (clinical)

CiteScore

9.80

自引率

5.70%

发文量

156

审稿时长

11 weeks

期刊介绍： npj Parkinson's Disease is a comprehensive open access journal that covers a wide range of research areas related to Parkinson's disease. It publishes original studies in basic science, translational research, and clinical investigations. The journal is dedicated to advancing our understanding of Parkinson's disease by exploring various aspects such as anatomy, etiology, genetics, cellular and molecular physiology, neurophysiology, epidemiology, and therapeutic development. By providing free and immediate access to the scientific and Parkinson's disease community, npj Parkinson's Disease promotes collaboration and knowledge sharing among researchers and healthcare professionals.