Subthalamic nucleus deep brain stimulation impacts language in early Parkinson's disease.
Subthalamic nucleus deep brain stimulation impacts language in early Parkinson's disease.
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DOI：
10.1371/journal.pone.0042829
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Charles PD
中科院分区：
文献类型：
--
作者：
Phillips L;Litcofsky KA;Pelster M;Gelfand M;Ullman MT;Charles PD
尽管基底神经节的脑深部电刺激（DBS）可以改善帕金森病（PD）的运动结果，但其对认知（包括语言）的影响仍不清楚。本研究探讨了丘脑底核DBS对语言的两种基本功能，即语法功能和词汇功能的影响。这些功能进行了测试与生产的规则和不规则的过去时态，对比方面的语法（规则）和词汇（不规则）处理，同时控制多个潜在的混淆因素。通过对比操纵（电机）和非操纵（非电机）对象的命名来测试电机系统的各个方面。比较了健康对照组和接受DBS/药物或单独药物治疗的早期PD患者的性能。患者接受治疗和停止治疗后进行评估，对照组遵循平行测试时间表。与对照组和仅使用药物的患者相比，STN-DBS改善了操纵（运动）但非操纵（非运动）对象的命名，这些患者在评估过程中彼此没有差异。相比之下，STN-DBS导致更差的表现在正规（语法），但不正规（词汇），相比其他两个主题组，谁再次没有差异。结果表明，STN-DBS对早期PD的语言产生负面影响，但可能是具体的语法和词汇处理方面的沮丧。STN-DBS影响运动和语法（但不是词汇）功能的发现加强了这两个依赖于基底神经节电路的观点，尽管其对这两个（改善运动，受损的语法）的差异影响的机制仍有待阐明。
Although deep brain stimulation (DBS) of the basal ganglia improves motor outcomes in Parkinson's disease (PD), its effects on cognition, including language, remain unclear. This study examined the impact of subthalamic nucleus (STN) DBS on two fundamental capacities of language, grammatical and lexical functions. These functions were tested with the production of regular and irregular past-tenses, which contrast aspects of grammatical (regulars) and lexical (irregulars) processing while controlling for multiple potentially confounding factors. Aspects of the motor system were tested by contrasting the naming of manipulated (motor) and non-manipulated (non-motor) objects. Performance was compared between healthy controls and early-stage PD patients treated with either DBS/medications or medications alone. Patients were assessed on and off treatment, with controls following a parallel testing schedule. STN-DBS improved naming of manipulated (motor) but not non-manipulated (non-motor) objects, as compared to both controls and patients with just medications, who did not differ from each other across assessment sessions. In contrast, STN-DBS led to worse performance at regulars (grammar) but not irregulars (lexicon), as compared to the other two subject groups, who again did not differ. The results suggest that STN-DBS negatively impacts language in early PD, but may be specific in depressing aspects of grammatical and not lexical processing. The finding that STN-DBS affects both motor and grammar (but not lexical) functions strengthens the view that both depend on basal ganglia circuitry, although the mechanisms for its differential impact on the two (improved motor, impaired grammar) remain to be elucidated.
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