Parkinson Hastalarında Subtalamik Çekirdek Derin Beyin Stimülasyonu Tedavisinin Motor Dışı Belirtilere ve Uyku Kalitesine Etkisi

Nazan ŞİMŞEK ERDEM, Gokce Yagmur GUNES GENCER, Sehür Sibel Özkaynak, Tanju Uçar
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Abstract

Objective: To evaluate the effect of subthalamic nucleus deep brain stimulation (STN-DBS) on non-motor symptoms (NMS), sleep quality, and excessive daytime sleepiness in patients with Parkinson’s Disease (PD). Material-Method: Sixteen PD patients, who had undergone bilateral STN-DBS surgery were enrolled. The patients were assessed at the baseline and 12 months after surgery using the Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire (PDQ-39), Beck Depression Inventory-II (BDI), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Non-Motor Symptom Questionnaire (NMS-Quest). Results: The mean age of the patients at the time of surgery was 53.5±3.6 years. There were significant improvements in the levodopa-equivalent daily dose, UPDRS-part-II, UPDRS-part-III, and UPDRS-part-IV at 12 months post-DBS surgery. The NMS-Quest total score at baseline was correlated with the disease duration of the patients (p=0.005 R:0.66). The PSQI score at baseline was significantly associated with a high total UPDRS and HADS score (p=0.03, p=0.004 respectively). There were no significant differences in terms of NMS-Quest total and subdomains thereof and PSQI total score and subdomains thereof, UPDRS-part I, BDI-II and HADS scores between baseline and 12 months post-DBS surgery (p>0.05 for all of them). Conclusion: STN-DBS surgery did not change subjective sleep quality, excessive daytime sleepiness, and NMS although it improved motor symptoms, motor fluctuations, and the health-related quality of life
目的:探讨丘脑底核深部脑刺激(STN-DBS)对帕金森病(PD)患者非运动症状(NMS)、睡眠质量和日间过度嗜睡的影响。材料-方法:入选16例行双侧STN-DBS手术的PD患者。采用统一帕金森病评定量表(UPDRS)、帕金森病问卷(PDQ-39)、贝克抑郁量表- ii (BDI)、医院焦虑抑郁量表(HADS)、匹兹堡睡眠质量指数(PSQI)、Epworth嗜睡量表(ESS)和非运动症状问卷(NMS-Quest)对患者进行基线和术后12个月的评估。结果:患者手术时平均年龄为53.5±3.6岁。dbs手术后12个月左旋多巴当量日剂量、UPDRS-part-II、UPDRS-part-III和UPDRS-part-IV均有显著改善。基线时NMS-Quest总分与患者病程相关(p=0.005 R:0.66)。基线时PSQI评分与较高的UPDRS和HADS总分显著相关(p=0.03, p=0.004)。两组患者NMS-Quest总分及其子域、PSQI总分及其子域、UPDRS-part I、BDI-II、HADS评分与dbs术后12个月比较,差异均无统计学意义(p>0.05)。结论:STN-DBS手术虽然改善了运动症状、运动波动和健康相关的生活质量,但并没有改变主观睡眠质量、白天过度嗜睡和NMS
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