Deep Brain Stimulation and Cognitive Outcomes Among Patients With Parkinson's Disease: A Historical Cohort Study.
Deep Brain Stimulation and Cognitive Outcomes Among Patients With Parkinson's Disease: A Historical Cohort Study.
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帕金森病患者的深部脑刺激和认知结果：一项历史队列研究。
DOI：
10.1176/appi.neuropsych.18050118
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Mehta,ShyamalH
中科院分区：
文献类型：
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作者：
Hansen,AllisonL;Krell-Roesch,Janina;Kirlin,KristinA;Limback-Stokin,MartinM;Roesler,Kimberly;Velgos,StefanieN;Lyons,MarkK;Geda,YonasE;Mehta,ShyamalH
目的脑深部电刺激（DBS）是治疗帕金森病运动症状的有效方法；然而，关于DBS对认知功能的影响，文献存在矛盾。作者对帕金森氏病患者进行了一项历史队列研究，这些患者接受了苍白球内部DBS （GPi， N=12）或丘脑底核DBS （STN， N=17）。方法研究脑刺激后6个月（随访）四项神经心理测试（即波士顿命名测试、WAIS言语理解指数、工作记忆指数和处理速度指数）与基线的差异。结果gpi DBS患者在基线和随访期间的所有神经心理测试均无差异。STN DBS患者的WAIS-PSI评分较低，表明随访时的表现较差（平均[SD]， 91.47[10.42]对81.65 [12.03];p=0.03）。STN DBS组和GPi DBS组的基线与随访WAIS-VCI评分变化之间存在显著差异（p=0.008）（即，与基线相比，STN DBS患者在6个月的随访中得分较低，而GPi DBS患者得分较高）。结论考虑到认知预后，sgpi可能是帕金森病患者DBS治疗的首选靶点。
ObjectiveDeep brain stimulation (DBS) is an effective treatment for motor symptoms of Parkinson’s disease; however, there is conflicting literature about the effect of DBS on cognitive function. The authors conducted a historical cohort study involving patients with Parkinson’s disease who underwent DBS of the globus pallidus pars interna (GPi; N=12) or subthalamic nucleus (STN; N=17).MethodsThe authors investigated differences in four neuropsychological test scores at 6 months post-DBS (follow-up) as compared with baseline (i.e., Boston Naming Test, WAIS Verbal Comprehension Index [WAIS-VCI], Working Memory Index [WAIS-WMI], and Processing Speed Index [WAIS-PSI]).ResultsGPi DBS patients showed no difference between baseline and follow-up on any neuropsychological test. STN DBS patients had lower scores indicating decreased performance at follow-up as compared with baseline on WAIS-PSI (mean [SD], 91.47 [10.42] versus 81.65 [12.03]; p=0.03). There was a significant (p=0.008) difference between the change in baseline to follow-up scores on the WAIS-VCI for the STN DBS and GPi DBS groups (i.e., STN DBS patients scored lower at the 6-month follow-up compared with baseline, whereas GPi DBS patients scored higher).ConclusionsGPi may be a preferred target for DBS in patients with Parkinson’s disease when considering cognitive outcomes.