DBS Effects on Mood and Cognition in Parkinsons Disease

DBS 对帕金森病患者情绪和认知的影响

• 批准号: 6805695
• 负责人: MICHAEL S OKUN
• 金额: $ 15.72万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-01 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6805695
• 关键词: Parkinson' s disease; brain electronic stimulator; clinical research; cognition; human subject; lenticular nucleus; mood disorders; neuroanatomy; neurology; neuropsychological tests; neuropsychology; patient oriented research; sensorimotor system; thalamic nuclei

DESCRIPTION (provided by applicant): Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus interna (GPi) has been demonstrated to be effective in the treatment of the cardinal motor symptoms of Parkinson's disease (PD) (tremor, rigidity, and bradykinesia). Both STN and GPi DBS have been documented to be effective in treating parkinsonian motor signs. Due to early limited reports, which suggest more robust improvements in UPDRS motor scores, and the ability to reduce parkinsonian medication with STN, but not GPi, STN has been the preferred target of most centers. There is, however, increasing evidence that STN DBS may be associated with a significant number of mood and cognitive changes. Because of the small size of the STN (158mm3), stimulation within the sensori-motor area can result in spread to limbic and associative areas of STN as well as to surrounding structures and fiber systems that may also affect mood and cognition. Since the Gpi (478mm3) is significantly larger than STN, a lead can be placed in the sensorimotor territory of the GPi with less likelihood of current spread to non-motor portions of the GPi or to adjacent structures and fiber systems that can adversely change mood and cognition. In this proposal we will 1) Characterize and compare the mood and cognitive changes associated with STN and GPi DBS, 2) delineate regions within or around the STN and GPi that are associated with specific mood and cognitive changes during DBS in these regions, and 3) assess the relative effect of right versus left STN or GPi stimulation on mood and cognition. This study will characterize the types and incidence of mood and cognitive changes that occur during stimulation in STN and GPi. It will also compare the relative changes in mood and cognition that occur in each site and examine the role of lead location in mediating them. The research is part of a five-year plan for training and career development for the Principal Investigator. This proposal includes active and experienced mentoring, access to diverse resources, and a scientific environment suited specifically for the development of the PI as an independent physician scientist.

描述（由申请人提供）：丘脑下核（STN）和Globus Pallidus Interna（GPI）的深脑刺激（DB）已被证明可以有效治疗帕金森氏病的基本运动症状（PD）（颤音，刚性，刚性，刚性，僵硬和乳腺癌）。 STN和GPI DBS均已记录在治疗帕金森氏症标志方面有效。由于早期的报告有限，这表明UPDRS运动得分的改进以及使用STN减少帕金森氏药物的能力，但STN是大多数中心的首选目标。但是，越来越多的证据表明STN DB可能与大量的情绪和认知变化有关。由于STN的尺寸较小（158mm3），感觉运动运动区域内的刺激可能会导致STN的边缘和关联区域以及可能影响情绪和认知的周围结构和纤维系统。由于GPI（478mm3）明显大于STN，因此可以将铅放置在GPI的感觉运动领域，而电流扩散到GPI的非运动部分或相邻结构和光纤系统的可能性较小，而这些可能性可能会不利地改变情绪和认知。在此提案中，我们将1）表征和比较与STN和GPI DBS相关的情绪和认知变化，2）在STN和GPI内部或周围的描述与这些区域中DBS期间的特定情绪和认知变化相关的STN和GPI周围的区域，以及3）评估右STN或GPI刺激对情绪和GPI刺激的相对效果。这项研究将表征在STN和GPI刺激期间发生的情绪和认知变化的类型和发生率。它还将比较每个站点中发生的情绪和认知的相对变化，并检查铅位置在中介它们中的作用。这项研究是首席研究员培训和职业发展五年计划的一部分。该建议包括积极和经验丰富的指导，获得多种资源的访问以及专门针对PI发展为独立医师科学家的科学环境。