丘脑底核脑深部电刺激对帕金森病抑郁障碍的影响

目的探讨丘脑底核脑深部电刺激对帕金森病病人抑郁障碍的疗效及其机制。方法回顾性分析21例帕金森病合并抑郁障碍病人的临床资料,均行丘脑底核脑深部电刺激术,术前及术后3、6个月分别应用汉密尔顿抑郁量表(HAMD)评分和统一帕金森病评定量表(UPDRS)运动评分对抑郁障碍和运动功能进行临床评价并分析其相关性。结果术后UPDRS运动评分和HAMD评分均显著下降(均P0.05),但是抑郁症状的改善与运动功能的改善并没有明显的相关性(P0.05)。结论丘脑底核脑深部电刺激能够明显改善帕金森病病人的抑郁症状,其机制可能与丘脑底核受到刺激影响脑内神经递质的变化有关,术后运动功能的改善不是抑郁症状改善的主要原因。

Effects of subthalamic nucleus deep brain stimulation on depression in Parkinson disease

Objective To investigate the effects of subthalamic nucleus-deep brain stimulation （STN-DBS） on depression in Parkinson disease （PD） and its mechanism. Methods The clinical data of 21 PD patients with depression were analyzed retrospectively. All the patients underwent STN-DBS. The depression and motor function were evaluated clinically by Hamilton depression scale （HAMD） and motor score of the unified PD rating scale （UPDRS） before and 3, 6 months after operation. The correlation between depression and motor fimction was analyzed. Results The postoperative HAMD scores and UPDRS motor scores decreased significantly 3, 6 months after / operation （all P〈0.05）. However, there was no correlation between the improvement in depressive symptoms and motor function （P〉0.05）. Conclusions STN-DBS can significantly improve the depressive symptoms of PD patients and the mechanism may be related to the changes in brain neurotransmitters. The improvement in motor function is not the main reason for the improvement in depressive symptoms.