Unilateral pallidal stimulation for Parkinson's disease: Neurobehavioral functioning before and 3 months after electrode implantation
Unilateral pallidal stimulation for Parkinson's disease: Neurobehavioral functioning before and 3 months after electrode implantation
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单侧苍白球刺激治疗帕金森病：电极植入前和植入后 3 个月的神经行为功能
作者：
A. Tröster;J. Fields;S. Wilkinson;R. Pahwa;E. Miyawaki;Kelly E. Lyons;W. Koller
单侧苍白球切开术被认为具有较低的认知疾病风险。尽管如此，最近的研究表明，一些患者的记忆和语言能力下降，而苍白质刺激可能是治疗帕金森病（PD）的一种更安全的方法。我们研究了单侧苍白质刺激的神经行为效应。连续9例PD患者在手术前1个月和手术后3个月分别接受单侧大脑深部刺激电极植入。患者报告术后焦虑症状明显减少，精力更充沛。抑郁症状有减少的趋势。语义语言流畅性和视觉结构测试分数在手术后显著下降。然而，在5例语义语言流畅性下降的患者中，只有1例患者的得分下降超过2个SD。没有患者表现出认知功能整体水平的显著下降或改善。从认知功能的角度来看，本研究支持单侧苍白质刺激治疗PD的相对安全性。
Unilateral pallidotomy is thought to have a low risk for cognitive morbidity. Nonetheless, recent research suggests that some patients experience declines in memory and language and that pallidal stimulation might be a safer treatment for Parkinson's disease (PD). We investigated the neurobehavioral effects of unilateral pallidal stimulation. Nine consecutive PD patients undergoing unilateral deep brain-stimulating electrode implantation in the globus pallidus interna were evaluated with a neuropsychological test battery approximately 1 month before and 3 months after surgery. Patients reported significantly fewer symptoms of anxiety and greater vigor after surgery. There was a trend toward fewer depressive symptoms. Semantic verbal fluency and visuoconstructional test scores declined significantly after surgery. However, among five patients showing declines in semantic verbal fluency, only one patient's score declined by more than 2 SD. No patient showed significant decline or improvement in the overall level of cognitive functioning. This study supports the relative safety, in terms of cognitive function, of unilateral pallidal stimulation in PD.