Nazan Şimşek Erdem, Gökçe Yağmur Güneş Gencer, Sehur Sibel Özkaynak, Tanju Uçar, Özge Doğanavşargil Baysal
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引用次数: 0
Abstract
Introduction: It is aimed to report the effects of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on motor symptoms, neuropsychiatric symptoms, and quality of life in Parkinson's Disease (PD) patients.
Methods: The results of 22 patients with PD, who had undergone bilateral STN-DBS, were analyzed. The Unified Parkinson's Disease Rating Scale (UPDRS) was applied to assess the patients' clinical characteristics before surgery and 6-, and 12-month follow-up after surgery. The quality of life of the patients was evaluated with the Parkinson's Disease Questionnaire (PDQ-39). Neuropsychological tests including Minnesota Impulse Control Disorders Interview (MIDI), Beck Depression Inventory-II (BDI), Hospital Anxiety and Depression Scale (HADS), Lille Apathy Rating Scale (LARS), and Mini-Mental State Examination (MMSE) were also routinely performed at baseline and 6 months and 12 months after surgery.
Results: The mean age of patients was 57.3±8.8 years. Fourteen patients (63.6%) were male. Significant improvements were seen in UPDRS-part-II, UPDRS-part-III UPDRS-part-IV, and PDQ-39 in the follow-ups after the surgery. No significant change was observed in 6- and 12-month follow-up visits for BDI, HADS, MMSE, and LARS, compared to baseline. A depressive episode, requiring antidepressant treatment was recorded in four (18.1%) patients. Before DBS surgery, eight patients had at least one current impulse control behaviors (ICBs). Among these eight patients; ICBs disappeared in one patient, did not change in two patients, and worsened in five patients after STN-DBS treatment.
Conclusion: In patients with a history of psychiatric disease, bilateral STN-DBS treatment may aggravate psychiatric symptoms such as depression, and ICBs.
简介:本研究旨在报道双侧丘脑底核深部脑刺激(STN-DBS)对帕金森病(PD)患者运动症状、神经精神症状和生活质量的影响。方法:对22例PD患者行双侧STN-DBS手术的结果进行分析。采用统一帕金森病评定量表(UPDRS)评估患者术前及术后6个月、12个月随访的临床特征。采用帕金森病问卷(PDQ-39)评估患者的生活质量。神经心理测试包括明尼苏达冲动控制障碍访谈(MIDI)、贝克抑郁量表- ii (BDI)、医院焦虑和抑郁量表(HADS)、里尔冷漠评定量表(LARS)和简易精神状态检查(MMSE),并在基线和术后6个月和12个月进行常规检查。结果:患者平均年龄57.3±8.8岁。男性14例(63.6%)。术后随访UPDRS-part-II、UPDRS-part-III、UPDRS-part-IV和PDQ-39均有显著改善。与基线相比,BDI、HADS、MMSE和LARS的6个月和12个月随访未观察到显著变化。4例(18.1%)患者出现抑郁发作,需要抗抑郁药物治疗。在DBS手术前,8例患者至少有一种当前冲动控制行为(ICBs)。8例患者中;经STN-DBS治疗后,1例患者ICBs消失,2例患者无变化,5例患者病情加重。结论:对有精神疾病史的患者,双侧STN-DBS治疗可能加重抑郁、ICBs等精神症状。
期刊介绍:
Archives of Neuropsychiatry (Arch Neuropsychiatry) is the official journal of the Turkish Neuropsychiatric Society. It is published quarterly, and four editions annually constitute a volume.
Archives of Neuropsychiatry is a peer reviewed scientific journal that publishes articles on psychiatry, neurology, and behavioural sciences. Both clinical and basic science contributions are welcomed. Submissions that address topics in the interface of neurology and psychiatry are encouraged. The content covers original research articles, reviews, letters to the editor, and case reports.