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

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Chinese Medical Journal 2015年第24期128卷 3371-3380页

作者： Xiao-Hong Wang Lin Zhang Laura Sperry John Olichney Sarah Tomaszewski Farias Kiarash Shahlaie norika malhado chang Ying Liu Su-Ping Wang Cui Wang Department of Neurology Dalian Municipal Central Hospital Dalian Liaoning 116033 China 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 Department of Neurology University Of Colorado Denver School of Medicine Denver CO USA

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 internus （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.

关键词： Deep Brain Stimulation Globus Pallidus lnternus Nonmotor Symptoms Parkinson's Disease Subthalamic Nucleus

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