Neuropsychological safety of nucleus accumbens deep brain stimulation for major depression: Effects of 12-month stimulation
Neuropsychological safety of nucleus accumbens deep brain stimulation for major depression: Effects of 12-month stimulation
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DOI：
10.3109/15622975.2011.583940
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发表时间：
2011-10-01
影响因子：
3.1
通讯作者：
Schlaepfer, Thomas E.
中科院分区：
文献类型：
--
作者：
Grubert, Christiane;Hurlemann, Rene;Schlaepfer, Thomas E.
目标。伏隔核脑深部电刺激(NAcc-DBS)对难治性抑郁症(TRD)患者有抗抑郁作用。然而，关于NAcc-DBS对认知功能的影响的信息有限。这项研究的目的是检查NAcc-DBS对TRD患者是否有认知影响。方法：研究方法。在双侧NAcc-DBS发作前和DBS刺激后1年，对10例TRD患者进行综合神经心理测试。神经心理测试涵盖了注意力、学习和记忆、执行功能、视觉感知和语言等领域。在基线和持续DBS一年后对绩效进行分析。结果。与NAcc-DBS治疗1年后的测试结果比较，没有发现NAcc-DBS治疗后认知能力下降的证据。然而，在注意力、学习和记忆、执行功能和视觉感知的测试中，发现认知表现显著改善。此外，认知提高的总体趋势是从低于平均水平到平均水平。这些先兆效应与NAcc-DBS的抗抑郁作用或NAcc-DBS参数的变化无关。结论。这些结果不仅支持NAcc-DBS的认知安全性，而且强调了它在提高TRD患者认知能力方面的有益作用。
Objectives. Deep brain stimulation (DBS) to the nucleus accumbens (NAcc-DBS) has antidepressant effects in patients suffering from treatment-resistant depression (TRD). However, limited information exists regarding the impact of NAcc-DBS on cognitive functioning. The aim of this study was to examine whether NAcc-DBS in patients with TRD has any cognitive effects. Methods. A comprehensive neuropsychological battery was administered to 10 patients with TRD before onset of bilateral NAcc-DBS and after 1 year of DBS stimulation. Neuropsychological testing covered the domains of attention, learning and memory, executive functions, visual perception, and language. Performance was analyzed at baseline and after 1 year of continuous DBS. Results. No evidence was found for cognitive decline following NAcc-DBS comparing test results after 1 year of NAcc-DBS with baseline. However, significantly improved cognitive performance on tests of attention, learning and memory, executive functions and visual perception was found. In addition, there was a general trend towards cognitive enhancement from below average to average performance. These procognitive effects were independent of the antidepressant effects of NAcc-DBS or changes in NAcc-DBS parameters. Conclusions. These results not only support cognitive safety of NAcc-DBS but also stress its beneficial role in augmenting cognitive performance in patients with TRD.