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Target Selection Recommendations Based on Impact of Deep Brain Stimulation Surgeries on Nonmotor Symptoms of Parkinson's Disease

摘要Objective: This review examines the evidence that deep brain stimulation (DBS) has extensive impact on nonmotor symptoms (NMSs) of patients with Parkinson's disease (PD).Data Sources: We retrieved information from the PubMed database up to September, 2015, using various search terms and their combinations including PD, NMSs, DBS, globus pallidus intemus (GPi), subthalamic nucleus (STN), and ventral intermediate thalamic nucleus.Study Selection: We included data from peer-reviewed journals on impacts of DBS on neuropsychological profiles, sensory function, autonomic symptoms, weight changes, and sleep disturbances.For psychological symptoms and cognitive impairment, we tried to use more reliable proofs: Random, control, multicenter, large sample sizes, and long period follow-up clinical studies.We categorized the NMSs into four groups: those that would improve definitively following DBS;those that are not significantly affected by DBS;those that remain controversial on their surgical benefit;and those that can be worsened by DBS.Results: In general, it seems to be an overall beneficial effect of DBS on NMSs, such as sensory, sleep, gastrointestinal, sweating, cardiovascular, odor, urological symptoms, and sexual dysfunction, GPi-DBS may produce similar results;Both STN and Gpi-DBS are safe with regard to cognition and psychology over long-term follow-up, though verbal fluency decline is related to DBS;The impact of DBS on behavioral addictions and dysphagia is still uncertain.Conclusions: As the motor effects of STN-DBS and GPi-DBS are similar, NMSs may determine the target choice in surgery of future patients.

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作者单位 Department of Neurology, Dalian Municipal Central Hospital, Dalian, Liaoning 116033, China [1] Department of Neurology, University of California Davis, Sacramento, CA, USA [2] Department of Neurology, University of California Davis, Sacramento, CA, USA;Center for Neuroscience, University of California Davis, Davis, CA, USA [3] Department of Neurology, University of California Davis, Sacramento, CA, USA;Center for Neuroscience, University of California Davis, Davis, CA, USA;Department of Neurological Surgery, University of California Davis, Sacramento, CA, USA [4]
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DOI 10.4103/0366-6999.171464
发布时间 2016-01-16(万方平台首次上网日期,不代表论文的发表时间)
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中华医学杂志(英文版)

中华医学杂志(英文版)

2015年128卷24期

3371-3380页

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