丘脑底核脑深部电刺激治疗帕金森病合并抑郁障碍的长期疗效

目的研究丘脑底核（STN）脑深部电刺激（DBS）治疗帕金森病（PD）合并抑郁障碍的长期疗效并探讨其神经机制。方法对15例合并抑郁障碍的PD患者实施STN脑深部电极植入，术后3个月、6个月和12个月进行随访和临床评价。结果术后运动功能症状如肢体僵硬、震颤、运动迟缓和姿势平衡障碍改善良好，停药后PD分级量表运动评分显著下降（P〈0．01）。术后抑郁障碍症状如焦虑、绝望和激越症状改善良好，停药后汉密尔顿抑郁量表评分显著下降（P〈0．05）。结论STN-DBS能显著改善PD的抑郁障碍症状，STN在PD抑郁障碍神经机制中起重要作用。

Long-term effects of deep brain stimulation of bilateral subthalamic nuclei on depressive disorder in Parkinson''''s disease

Objective To study the long-term effects of deep brain stimulation(DBS)of bilateral subthalamic nuclei(STN)on depressive disorder in Parkinson's disease(PD)and to discuss its neurological mechanism.Methods Fifteen PD patients with depressive disorder were selected for STN-DBS.Assessment was performed before and 3,6,12 months after surgery.Depression was evaluated using the Hamilton Rating Scale for Depression(HAMD).Assessment of the motor function was based on the unified PD Rating Scale(UPDRS).Results After surgery,the motor functional disorders such as limb stiffness,trembling,bradypraxia and balance disturbance were improved obviously,and the scores of UPDRS decreased significantly after drug withdrawal(P<0.01).The depressive disorders such as anxiety,despair and agitate were also alleviated and the scores of HAMD decreased significantly after drug withdrawal(P<0.05).Conclusion Bilateral STN-DBS improves the depressive symptoms in PD patients.The STN plays an important role in the pathophysiology of PD-related depression.