脑深部电刺激术对帕金森病患者非运动症状及生活质量的短期影响

Short-term effects of deep brain electrical stimulation on non-motor symptoms and quality of life in patients with Parkinson’s disease

目的研究脑深部电刺激术(DBS)对帕金森病(PD)患者非运动症状(NMS)及生活质量的短期影响。方法采用非运动症状量表(NMSS)、贝克抑郁量表第2版(BDI-Ⅱ)、中文版蒙特利尔认知评估量表(MoCA)、39项帕金森患者生活质量问卷(PDQ-39)评分对102例接受DBS治疗的PD患者进行评估。观察DBS治疗前及治疗后6个月患者NMS及生活质量的变化。结果与术前比较,患者术后NMSS认知维度评分无显著差异(P>0.05),性功能、泌尿系统、胃肠道症状、知觉/幻觉、睡眠/疲劳、头晕/跌倒、抑郁/焦虑、其他评分及NMSS总分均显著降低(P<0.05~0.01)。与术前相比,在BDI-Ⅱ评分及MoCA口语流畅度评分显著降低(P<0.05~0.01)。与术前比较,术后PDQ-39认知力维度评分差异无统计学意义(P>0.05),社会支持、躯体不适、交往、病耻感、日常活动能力、运动功能、情感维度评分和总分均显著减低(均P<0.05)。结论DBS短期内即可改善PD患者的抑郁、睡眠、泌尿系统症状、胃肠道症状等NMS及生活质量,对除口语流畅度以外的认知状态无明显影响。

Objective To study the short-term effect of deep brain stimulation(DBS)on non-motor symptoms(NMS)and quality of life in patients with Parkinson’s disease(PD).Methods One hundred and two PD patients who received DBS were evaluated with NMS scale for Parkinson(NMSS),Beck depression inventory-Ⅱ(BDI-Ⅱ),Montreal cognitive assessment(MoCA)Chinese version and the 39-item Parkinson’s disease questionnaire(PDQ-39).The changes in NMS and quality of life of patients before and at 6 th month after DBS treatment were observed.Results Compared with those before procedure,there was no significant difference in NMSS cognitive dimension score after procedure(P>0.05),the scores of sexual function,urinary system symptoms,gastrointestinal symptoms,perception/hallucination,sleep/fatigue,dizziness/falls,depression/anxiety,other scores and total NMSS scores after procedure were significantly decreased(P<0.05-0.01).Compared with those before procedure,the BD-Ⅱscore and the oral fluency score of MoCA after procedure were significantly decreased(P<0.05-0.01).Compared with those before procedure,there was no significant difference in cognitive dimension score of PDQ-39 after procedure(P>0.05),the scores of social support,physical discomfort,communication,sense of shame,daily activity ability,motor function,emotion and total PDQ-39 scores were significantly lower after procedure(all P<0.05).Conclusion DBS can improve the NMS and quality of life of PD patients in the short term,such as depression,sleep,urinary system symptoms,gastrointestinal symptoms,and has no significant effect on cognitive status except oral fluency.