论文部分内容阅读
目的 :评估丘脑底核(subthalamic nucleus,STN)脑深部电刺激术(deep brain stimulation,DBS)对帕金森病(Parkinson’s disease,PD)患者认知功能的影响,并探讨其潜在的发生机制。方法 :40例PD患者中,20例PD接受双侧STN-DBS治疗(DBS组);另20例因拒绝手术,采用最佳药物进行治疗(药物治疗组),设20例健康者作为对照(对照组)。采用神经心理学方法对STN-DBS前1周、术后1年及药物治疗患者随访1年前、后的认知功能进行评估,并与20例匹配的健康对照者进行比较。结果:STN-DBS术后患者运动症状明显改善,但执行错误率明显升高(P<0.05),言语流畅性明显下降(P<0.05)。结论:STN-DBS可引起PD患者执行功能及言语流畅性的下降,但对于术前无严重认知功能障碍的患者,STN-DBS术后短期内引起的认知改变并不影响其生活质量。
Objective: To evaluate the effect of deep brain stimulation (DBS) on cognitive function in patients with Parkinson’s disease (PD) by subthalamic nucleus (STN) and explore its underlying mechanism. Methods: Forty patients with PD were treated with bilateral STN-DBS (DBS group), while 20 patients were treated with the best drug (drug-treated group) due to the refusal of surgery. Twenty healthy controls were included as controls Control group). Neuropsychological methods were used to evaluate the cognitive function of STN-DBS in the first week, one year after surgery and one year before and after follow-up of drug treatment, and compared with 20 matched healthy controls. Results: The symptoms of patients with STN-DBS were significantly improved, but the error rate of execution was significantly increased (P <0.05) and the speech fluency was significantly decreased (P <0.05). CONCLUSIONS: STN-DBS can cause a decrease in executive function and verbal fluordination in patients with PD. However, short-term cognitive changes caused by STN-DBS do not affect the quality of life of patients with preoperative no cognitive impairment.