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在帕金森病中进行深度大脑刺激手术后,术后痴呆症的危险因素严重程度

Melanie Astalosch^1,2, Mahta Mousavi³, Luísa Martins Ribeiro^1,4

¹Department of Neurology and Experimental Neurology, Movement Disorder and Neuromodulation Unit, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Journal of Parkinson's disease

|July 26, 2024

概括

在帕金森病 (PD) 中深度大脑刺激 (DBS) 后的术后妄 (POD) 受年龄,认知缺陷和大脑结构的影响. 识别这些风险因素可以帮助预测POD的严重程度.

科学领域:

神经学神经学
神经外科神经外科
认知神经科学认知神经科学

背景情况:

手术后妄 (POD) 是深度大脑刺激 (DBS) 手术后的严重并发症,特别是在帕金森病 (PD) 患者中.
较高的年龄和先前存在的认知障碍是已知的POD风险因素,也可能预测DBS后的长期认知衰退.
经过DBS后的POD在历史上得到了有限的研究关注,尽管它可能对患者的治疗结果产生影响.

研究的目的:

鉴定和分析与手术后狂妄症 (POD) 严重程度相关的关键风险因素,用于对帕金森病 (PD) 进行深度大脑刺激 (DBS) 的患者.
为了更好地了解POD严重程度的预测因素,以告知临床实践和患者管理策略.

主要方法:

研究了一组57名帕金森病 (PD) 患者接受深度大脑刺激 (DBS).
术前评估包括一般健康状况,PD特异性因素,认知测试 (蒙特利尔认知评估,CANTAB ConnectTM) 和基底前脑的基于voxel的形态测量.
使用ICU (CAM-ICU) 和护理 Delirium Scale (NU-DESC) 的混评估方法评估POD严重程度,使用包括斯皮尔曼相关性和多变量线性回归在内的统计分析.

主要成果:

大约36.8%的患者在DBS手术后经历了轻度的POD.
预测POD严重程度的重要预测因素包括晚年,注意力缺陷,运动速度,视觉学习和工作记忆.
减少Meynert基底核和手术内突发抑制的体积也与POD严重程度的增加密切相关.

结论:

无论是一般患者因素还是PD特定的和与手术相关的变量,都能显著预测DBS后的POD严重程度.
这些发现凸显了这种患者群体中POD的复杂,多因素性质.
在PD中DBS后的POD的未来预测模型应该整合一套全面的一般性,疾病特异性和手术因素.

关键词:

帕金森病是帕金森氏症的一种疾病.认知认知认知深度大脑刺激刺激大脑结果结果结果结果.个性化治疗是个性化的治疗.术后狂妄症的发生风险预测风险预测

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