A two-year survey on non-motor symptoms after bilateral subthalamic nucleus deep brain stimulation in patients with Parkinson's disease

doi:10.19854/j.cnki.1008-2425.2023.04.0001

Abstract

Abstract: Objective To investigate the changes of non-motor symptoms and quality of life in patients with Parkinson's disease (PD) after bilateral subthalamic nucleus deep brain stimulation (STN-DBS).Methods Questionnaires were conducted among a convenience sample of 45 PD patients who met the indications of STN-DBS in the Functional Neurosurgery Center of Ruijin Hospital,Shanghai JiaoTong University School of Medicine in Shanghai from June 1,2020 to August 31,2020.The Non-motor Symptom Scale (NMSS) and 8-item Parkinson's Disease Questionnaire (PDQ-8) were used to evaluate the patients' non-motor symptoms and quality of life preoperatively and at 3,6,12 and 24-month postoperative visits.Results Generalized estimation equation analysis showed a significant overall change of PDQ-8 and levodopa equivalent daily dose (LEDD) over five follow-up visits (P＜0.05).Sleep/fatigue,Mood/apathy,Attention/memory,Gastrointestinal,Urinary,Sexual function and Miscellaneous subscores showed a statistically significant decreasing trend (P＜0.05),while Cardiovascular and Perceptual subscores of NMSS were unchanged (P>0.05).Conclusion Bilateral STN-DBS has a long-term benefit on sleep/fatigue and urinary symptoms and a short-term benefit on Sleep/fatigue,Mood/apathy,Attention/memory,Gastrointestinal,Urinary,Sexual function and Miscellaneous symptoms in PD patients.Moreover,it can reduce the medication intake and improve the patients' quality of life.

Key words: Parkinson's disease, Deep brain stimulation, Non-motor symptoms, Qualityoflife, Longitudinal study

摘要： 目的了解帕金森病患者行双侧丘脑底核脑深部电刺激术(STN-DBS)后非运动症状及生活质量的变化情况。方法采取便利抽样法,对上海交通大学医学院附属瑞金医院功能神经外科中心2020年6月1日至2020年8月31日符合双侧STN-DBS疗法适应证的帕金森病患者45人进行问卷调查,运用患者一般资料调查表、非运动症状量表(NMSS)及8项帕金森病调查表(PDQ-8)对患者术前及术后3个月、6个月、12个月及24个月时非运动症状及生活质量的情况进行评估与分析。结果经广义估计方程分析发现,患者术后PDQ-8、左旋多巴每日等效剂量(LEDD)的5次随访的整体变化是具有统计学意义的(P＜0.05),NMSS中,心血管维度和感知障碍维度的整体变化没有统计学意义(P＞0.05),而睡眠/疲劳、情绪/冷漠、注意力/记忆、胃肠道症状、泌尿系统症状、性功能及混合症状的整体变化均具有统计学意义(P＜0.05)。结论双侧STN-DBS术可长期改善帕金森病患者的睡眠/疲劳及泌尿系统症状;在短期内改善情绪/冷漠、注意力/记忆及性功能;对胃肠道症状及混合症状均具有一定的改善作用;同时可减少患者药物治疗的剂量,提高患者的生活质量。

关键词: 帕金森病, 脑深部电刺激, 非运动症状, 生活质量, 纵向研究

CLC Number:

R742.5

Wang Jue, Qiu Xian, Gao Ying, et al. A two-year survey on non-motor symptoms after bilateral subthalamic nucleus deep brain stimulation in patients with Parkinson's disease[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2023, 36(4): 193-199.

王珏, 邱娴, 高颖, 寿文华, 徐露, 李殿友, 王林斌, 孙伯民, 朱大乔. 帕金森病患者双侧丘脑底核脑深部电刺激术后2年非运动症状的研究[J]. 立体定向和功能性神经外科杂志, 2023, 36(4): 193-199.

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