Association between electrode fusion error and depression improvement during subthalamic nucleus-deep brain stimulation in PD
10.3969/j.issn.1009-0126.2024.10.011
- VernacularTitle:帕金森病丘脑底核脑深部电刺激器术中电极融合误差与抑郁改善关联性探究
- Author:
Junju LI
1
;
Qingzhi LI
;
Jiahao HU
;
Bin MO
Author Information
1. 570311 海口,海南省人民医院神经外科
- Keywords:
Parkinson disease;
subthalamic nucleus;
electric stimulation;
levodopa
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(10):1167-1172
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the association between electrode fusion error and improve-ment of depression during subthalamic nucleus-deep brain stimulation(STN-DBS)surgery for Parkinson's disease(PD).Methods A prospective trial was conducted on 240 PD patients under-going STN-DBS treatment in our hospital from January 2020 to December 2022.According to their clinical outcomes,they were divided into effective group(211 cases)and ineffective group(29 cases).The electrode fusion error was compared among the patients with different efficacy,psychological status,and cognitive status to analyze the correlation of electrode fusion error dur-ing STN-DBS surgery with improvement of depression and cognition.Results There were no sig-nificant differences between the effective group and ineffective group in terms of gender,age,body mass index,hypertension,diabetes,hyperlipidemia,disease duration,or preoperative MMSE and PDQ-39 scores(P＞0.05).STN-DBS treatment resulted in obviously improved clinical symptoms such as tremor,rigidity and bradykinesia,and higher UPDRSⅢ score when compared with the re-sults of preoperative impact test(P＜0.01).Before treatment,no statistical differences were ob-served in the scores of SAS,SDS,MoCA,MMSE,Alzheimer's disease assessment scale cognitive subscale(ADAS-Cog)or Chinese medicine syndrome change overall impression scale(CGIC-S)between the effective and ineffective groups(P＞0.05).After treatment,the scores of SAS,SDS,CGIC-S and ADAS-Cog were declined(P＜0.01),and these four scores was notably lower in the effective than the ineffective groups(P＜0.01).The scores of MoCA and MMSE were significant-ly elevated in both groups after surgery(P＜0.01),and the scores were higher in the effective group than the ineffective group(P＜0.01).The target coordinate deviation on the left and right was significantly higher in the patients with SDS≥53 and SAS≥50 than those of SDS＜53 and SAS＜50(P＜0.01).The target coordinate deviation on the left and right of the patients with MoCA＜26,MMSE＜27,ADAS-Cog≥36 and CGIC-S＞1 was statistically higher than that of the patients with MoCA≥ 26,MMSE≥27,ADAS-Cog＜36 and CGIC-S≤1(P＜0.01).Correlation analysis displayed that the bilateral fusion error of patients was negatively correlated with MoCA and MMSE scores(r=-0.678,P＜0.01;r=-0.653,P＜0.01;r=-0.448,P＜0.01;r=-0.704,P＜0.01),and positively with ADAS-Cog,CGIC-S,SDS and SAS scores(r=0.586,P＜0.01;r=0.501,P＜0.01;r=0.572,P＜0.01;r=0.601,P＜0.01;r=0.742,P＜0.01;r=0.667,P＜0.01;r=0.463,P＜0.01;r=0.381,P＜0.01).Conclusion In PD treatment,electrode fusion error during STN-DBS is significantly correlated with improvement of depression and cognitive score,which can be used as one of the important evidence for predicting clinical effectiveness.In the future,according to the intraoperative error,auxiliary treatment can be carried out timely and effectively to guide further clinical treatment.
