Clinical study of deep brain stimulation for non ⁃ motor symptoms in Parkinson's disease

Abstract

Objective To investigate the therapeutic effect of deep brain stimulation (DBS) on non⁃motor symptoms of Parkinson's disease (PD). Methods A total of 41 patients with PD who underwent DBS in Tianjin Huanhu Hospital from January 2015 to January 2021 were selected as subjects. The cognitive function was assessed by Mini⁃Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at 3, 6 and 12 months after operation. Beck Depression Inventory Ⅱ (BDI⁃Ⅱ) and Hamilton Anxiety Rating Scale (HAMA) assessed depression and anxiety, Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) assessed sleep disorders and sleepiness, and Unified Parkinson's Disease Rating Scale Ⅲ (UPDRSⅢ) assessed motor symptoms. Levodopa equivalent daily dose (LEDD) was used to assess postoperative dependence on anti⁃PD drugs. Results The BDI⁃Ⅱscore (P=0.000), HAMA total scores (P=0.000) and its somatic anxiety (P=0.000), mental anxiety (P=0.000), PSQI total scores (P=0.000) and its subjective sleep quality (P=0.000), time to fall asleep (P=0.000), sleep duration (P=0.000), sleep efficiency (P=0.000), sleep disorders (P=0.000), sleep drug use (P=0.015), daytime dysfunction (P=0.000), ESS score (P=0.000), UPDRSⅢ score (P=0.000) and LEDD (P=0.000) had statistically significant differences before and after surgery. The improvement rates of BDI⁃Ⅱ, HAMA, PSQI and ESS were 46.00%, 33.58%, 34.67% and 34.30%, 49.69%, 35.01%, 38.19% and 36.20%, 50.51%, 35.24%, 39.77% and 39.44% at 3, 6 and 12 months after surgery respectively. The scores at different postoperative observation points were significantly different from those before surgery (P＜0.01, for all). However, there were no significant differences in MMSE total scores and its score of orientation, memory, attention and computation, recall ability and language function, as well as MoCA total scores and its score of visual spatial and executive function, naming, attention, language, abstraction, delayed recall and orientation before and after surgery (P＞0.05, for all). Conclusions DBS can significantly improve the motor symptoms, mood and sleep disorder of non⁃motor symptoms (NMS) in PD patients, and reduce the dose of anti⁃PD drugs, but has no effect on cognitive function.

doi：10.3969/j.issn.1672⁃6731.2022.04.010