Subthalamic deep brain stimulation and impulse control in Parkinson's disease
Subthalamic deep brain stimulation and impulse control in Parkinson's disease
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DOI：
10.1111/j.1468-1331.2008.02509.x
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发表时间：
2009-04-01
影响因子：
5.1
通讯作者：
Olanow, C. W.
中科院分区：
文献类型：
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作者：
Halbig, T. D.;Tse, W.;Olanow, C. W.
实验研究表明，脑深部刺激（DBS）丘脑下核（STN）可诱导帕金森病（PD）患者的冲动。本研究的目的是评估PD合并STN DBS患者与接受药物治疗的患者的各种冲动控制措施。在横断面评估中，53名连续符合条件的患者使用Barratt冲动量表评估冲动性，使用明尼苏达冲动性障碍访谈评估冲动性控制障碍（ICDs），使用莫兹利强迫症量表评估强迫症症状。独立样本t检验显示，DBS患者和非DBS患者的强迫得分没有差异。然而，DBS患者的冲动得分明显更高。此外，16例DBS患者中有3例（19%）和37例接受药物治疗的患者中有3例（8%）出现icd。在DBS患者中，没有发现多巴胺激动剂的使用与冲动之间的关联。我们的数据表明，应该在DBS之前进行冲动和icd筛查，并且应该在随访期间监测患者是否存在这些问题。需要前瞻性试验来证实这一探索性研究的发现，并阐明STN DBS可能诱发冲动的原因。
Experimental studies suggest that deep brain stimulation (DBS) of the subthalamic nucleus (STN) induces impulsivity in patients with Parkinson's disease (PD). The purpose of this study was to assess various measures of impulse control in PD patients with STN DBS in comparison to patients receiving medical therapy.In a cross-sectional evaluation, 53 consecutively eligible patients were assessed for impulsivity with the Barratt Impulsiveness Scale, for impulse control disorders (ICDs) using the Minnesota Impulsive Disorders Interview, and for obsessive-compulsive symptoms using the Maudsley Obsessional-Compulsive Inventory.Independent samples t-tests revealed that compulsivity scores were not different between DBS patients and patients without DBS. However, impulsivity scores were significantly higher in DBS patients. Additionally, ICDs were observed in 3 of 16 (19%) DBS patients and in 3 of 37 (8%) medically treated patients. No association was found between the use of dopamine agonists and impulsivity in DBS patients.Our data suggest that screening for impulsivity and ICDs should be performed prior to DBS, and that patients should be monitored for these problems during follow-up. Prospective trials are needed to confirm the findings of this exploratory study and to elucidate the reasons of a possible induction of impulsivity by STN DBS.