EFFECTS OF DEEP BRAIN STIM ON MOOD AND COGNITIVE SYMPTOMS IN PARKINSONS DIS

深部脑刺激对帕金森病患者情绪和认知症状的影响

• 批准号: 7374636
• 负责人: MICHAEL S OKUN
• 金额: $ 6.27万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7374636
• 关键词: EFFECTS; DEEP; BRAIN; STIM; MOOD

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. 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 signs of Parkinson¿s disease (PD) (tremor, rigidity, and bradykinesia). 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[1]. There is, however, increasing evidence that STN DBS may be associated with a significant number of mood and cognitive changes[2-10]. 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 (478 mm3) is significantly larger than the STN[11], 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. The major aim of this study is to carry out a prospective clinical trial investigating the effect of STN and GPi DBS on mood and cognitive function. 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.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构是针对该中心的，这不是调查人员的机构。丘脑下核（STN）和Globus pallidus interna（GPI）的深脑刺激（DBS）已被证明可以有效治疗帕金森氏病（PD）的基本运动迹象（震颤，僵硬，刚性，刚性和脑力区）。由于早期的报告有限，这表明UPDRS的运动得分有了更大的改进，并且能够减少使用STN但不是GPI的帕金森氏药物的能力，因此STN是大多数中心的首选目标[1]。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[2-10]。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 [11]，因此可以将铅放置在GPI的感觉运动区域，而电流扩散到GPI的非运动部分或相邻的结构和纤维系统的可能性较小，或者可以不利地改变情绪和认知。这项研究的主要目的是进行一项前瞻性临床试验，研究STN和GPI DBS对情绪和认知功能的影响。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事件。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。