Deep brain stimulation versus nonsurgical treatment for severe Alzheimer's disease: A long-term retrospective cohort study.

IF 2.8 Q2 NEUROSCIENCES
Journal of Alzheimer's disease reports Pub Date : 2024-12-23 eCollection Date: 2024-01-01 DOI:10.1177/25424823241297852
Junpeng Xu, Bin Liu, Zhebin Feng, Xinguang Yu, Guosong Shang, Yang Liu, Yuxiang Sun, Haonan Yang, Yuhan Chen, Yanyang Zhang, Zhiqi Mao
{"title":"Deep brain stimulation versus nonsurgical treatment for severe Alzheimer's disease: A long-term retrospective cohort study.","authors":"Junpeng Xu, Bin Liu, Zhebin Feng, Xinguang Yu, Guosong Shang, Yang Liu, Yuxiang Sun, Haonan Yang, Yuhan Chen, Yanyang Zhang, Zhiqi Mao","doi":"10.1177/25424823241297852","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Severe Alzheimer's disease (AD) is characterized by significant neuropsychiatric symptoms and sleep disorders, with limited effectiveness of conservative drug treatments. Deep brain stimulation (DBS) offers a potential alternative.</p><p><strong>Objective: </strong>To evaluate the efficacy, safety, and long-term outcomes of DBS versus conservative treatment in patients with severe AD.</p><p><strong>Methods: </strong>We retrospectively analyzed 40 patients with severe AD diagnosed at the People's Liberation Army General Hospital from 2015 to 2022. Twenty patients received DBS, and twenty received conservative treatment. Treatment effects were assessed using standardized scales at three- and twelve-months post-treatment. Primary outcomes included changes in cognitive function [Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Alzheimer's Disease Rating Scale-Cognitive subscale, Clinical Dementia Rating). Secondary outcomes included quality of life, sleep quality, neuropsychiatric symptoms, and caregiver burden (Barthel Index, Functional Activity Questionnaire, Functional Independence Measure (FIM), Neuropsychiatric Inventory (NPI), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Pittsburgh Sleep Quality Index (PDQI), Zarit Burden Interview (ZBI)].</p><p><strong>Results: </strong>DBS patients showed significantly greater improvements in MMSE, MoCA, FIM, and ZBI scores than controls, suggesting improved cognitive function and quality of life, and reduced caregiver burden (p < 0.05). Notably, DBS significantly reduced HAM-A, HAM-D, and PSQI scores, and improved NPI scores more than controls, indicating significant amelioration of neuropsychiatric symptoms and sleep disorders (p < 0.05).</p><p><strong>Conclusions: </strong>DBS is a safe and reversible treatment that potentially enhances cognitive function and quality of life in severe AD patients and alleviates caregiver burden. For the first time, we report that DBS also improves neuropsychiatric symptoms and sleep disorders, highlighting its clinical potential in AD.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"8 1","pages":"1677-1689"},"PeriodicalIF":2.8000,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863731/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Alzheimer's disease reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/25424823241297852","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Severe Alzheimer's disease (AD) is characterized by significant neuropsychiatric symptoms and sleep disorders, with limited effectiveness of conservative drug treatments. Deep brain stimulation (DBS) offers a potential alternative.

Objective: To evaluate the efficacy, safety, and long-term outcomes of DBS versus conservative treatment in patients with severe AD.

Methods: We retrospectively analyzed 40 patients with severe AD diagnosed at the People's Liberation Army General Hospital from 2015 to 2022. Twenty patients received DBS, and twenty received conservative treatment. Treatment effects were assessed using standardized scales at three- and twelve-months post-treatment. Primary outcomes included changes in cognitive function [Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Alzheimer's Disease Rating Scale-Cognitive subscale, Clinical Dementia Rating). Secondary outcomes included quality of life, sleep quality, neuropsychiatric symptoms, and caregiver burden (Barthel Index, Functional Activity Questionnaire, Functional Independence Measure (FIM), Neuropsychiatric Inventory (NPI), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Pittsburgh Sleep Quality Index (PDQI), Zarit Burden Interview (ZBI)].

Results: DBS patients showed significantly greater improvements in MMSE, MoCA, FIM, and ZBI scores than controls, suggesting improved cognitive function and quality of life, and reduced caregiver burden (p < 0.05). Notably, DBS significantly reduced HAM-A, HAM-D, and PSQI scores, and improved NPI scores more than controls, indicating significant amelioration of neuropsychiatric symptoms and sleep disorders (p < 0.05).

Conclusions: DBS is a safe and reversible treatment that potentially enhances cognitive function and quality of life in severe AD patients and alleviates caregiver burden. For the first time, we report that DBS also improves neuropsychiatric symptoms and sleep disorders, highlighting its clinical potential in AD.

深部脑刺激与非手术治疗重度阿尔茨海默病:一项长期回顾性队列研究
背景:重度阿尔茨海默病(AD)以显著的神经精神症状和睡眠障碍为特征,保守药物治疗效果有限。深部脑刺激(DBS)提供了一个潜在的替代方案。目的:评价DBS与保守治疗在重度AD患者中的疗效、安全性和长期预后。方法:回顾性分析2015年至2022年在中国人民解放军总医院诊断的40例重度AD患者。20例患者接受DBS治疗,20例患者接受保守治疗。在治疗后3个月和12个月使用标准化量表评估治疗效果。主要结局包括认知功能的改变[简易精神状态检查(MMSE)、蒙特利尔认知评估(MoCA)、阿尔茨海默病评定量表-认知亚量表、临床痴呆评定量表]。次要结局包括生活质量、睡眠质量、神经精神症状和照顾者负担(Barthel指数、功能活动问卷、功能独立量表(FIM)、神经精神量表(NPI)、汉密尔顿焦虑评定量表(HAM-A)、汉密尔顿抑郁评定量表(HAM-D)、匹兹堡睡眠质量指数(PDQI)、Zarit负担访谈(ZBI))。结果:DBS患者在MMSE、MoCA、FIM和ZBI评分上的改善明显大于对照组,表明认知功能和生活质量得到改善,并减轻了照顾者负担(p)。结论:DBS是一种安全、可逆的治疗方法,有可能提高重度AD患者的认知功能和生活质量,减轻照顾者负担。我们首次报道了DBS还能改善神经精神症状和睡眠障碍,突出了其在阿尔茨海默病中的临床潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.80
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信