• 四川大學華西醫(yī)院神經(jīng)內(nèi)科（成都，610041）;

【摘要】 帕金森病（Parkinson’s disease， PD）是中老年人常見的神經(jīng)系統(tǒng)變性疾病。腦深部電刺激（deep brain stimulation， DBS）可以改善中晚期或藥物難治性PD患者的運動癥狀、生活質(zhì)量，并且丘腦底核腦深部電刺激（subthalamic nucleus deep brain stimulation， STN DBS）還可減少術(shù)后多巴胺能藥物的治療劑量，但DBS術(shù)后同時可出現(xiàn)認知功能、行為、情緒和精神等方面的變化。目前DBS對認知功能如語言功能、執(zhí)行功能、記憶力、注意力、視功能和精神運動速度等方面的影響尚無一致的結(jié)論，現(xiàn)就DBS對認知功能各方面的影響進行綜述。

引用本文： 李楠楠,袁強,彭蓉. 腦深部電刺激對帕金森病認知功能的影響. 華西醫(yī)學, 2011, 26(1): 129-132. doi: 復制

1. 　Silberstein P, Bittar RG, Boyle R, et al. Deep brain stimulation for Parkinson’s disease: Australian referral guidelines[J]. J Clin Neurosci, 2009, 16(8): 1001-1008.
2. 　Gaspair DD, Siri C, Gioia MD, et al. Clinical correlates and cognitive underpinnings of verbal fluency impairment after chronic subthalamic stimulation in Parkinson’s disease[J]. Parkinsonism Relat Disord, 2006, 12(5): 289-295.
3. 　Parsons TD, Rogers SA, Braaten AJ, et al. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: a meta-analysis[J]. Lancet Neurol, 2006, 5(7): 578-588.
4. 　Funkiewiez A, Ardouin C, Caputo E, et al. Long-term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood and behaviour in Parkinson’s disease[J]. J Neurol Neurosurg Psychiatry, 2004, 75(6): 834-839.
5. 　Castelli L, Rizzi L, Zibetti M, et al. Neuropsychological changes 1-year after subthalamic DBS in PD patients: A prospective controlled study[J]. Parkinsonism Relat Disord, 2010, 16(2): 115-118.
6. 　Zangaglia R, Pacchetti C, Pasotti C, et al. Deep brain stimulation and cognitive functions in Parkinson’s disease: a three-year controlled study[J]. Mov Disord, 2009, 24(11): 621-1628.
7. 　Schroeder U, KuehlerA, Lange KW, et al. Subthalamic nucleus stimulation affects a frontotemporal network: a PET study[J]. Ann Neurol, 2003, 4(4): 445-450.
8. 　Troster AI, Woods SP, Fields JA, et al. Declines in switching underlie verbal fluency changes after unilateral pallidal surgery in Parkinson’s disease[J]. Brain Cogn, 2002, 50(2): 207-217.
9. 　Okun MS, Fernandez HH, Wu SS, et al. Cognition and mood in Parkinson’s disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: the compare Trial[J]. Int J Geriatr Psychiatry, 2009, 24: 443-451.
10. 　Whelan BM, Murdoch BE, Theodoros DG, et al. Beyond verbal fluency: investigating the long-term effects of bilateral subthalamic (STN) deep brain stimulation (DBS) on language function in two cases[J]. Neurocase, 2005, 11(2): 93-102.
11. 　Fraraccio M, Ptito A, Sadikot A, et al. Absence of cognitive deficits following deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease[J]. Arch Clin Neuropsychol, 2008, 23(4): 399-408.
12. 　Daniels C, Krack P, Volkmann J, et al. Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson’s disease[J]. Mov Disord, 2010, 25(11): 1583-1589.
13. 　Balaz M, Rektor I, Pulkrabek J, et al. Participation of the subthalamic nucleus in executive functions: an intracerebral recording study[J]. Mov Disord, 2008, 23(4): 553-557.
14. 　Contarino MF, Daniele A, Sibilia AH, et al. Cognitive outcome 5 years after bilateral chronic stimulation of subthalamic nucleus in patients with Parkinson’s disease[J]. Neurol Neurosurg Psychiatry, 2007, 78(3): 248-252.
15. 　Heo JH, Lee KM, Paek SH, et al. The effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) on cognition in Parkinson disease[J]. J Neurol Sci, 2008, 273(1-2): 19-24.
16. 　Jahanshahi M, Ardouin CM, Brown RG, et al. The impact of deep brain stimulation on executive function in Parkinson’s disease[J]. Brain, 2000, 123 (Pt 6): 1142-154.
17. 　Hu R, Eskandar E, Williams Z, et al. Role of deep brain stimulation in modulating memory formation and recall[J]. Neurosurg Focus, 2009, 27(1): E3.
18. 　Hlbig TD, Gruber D, Kopp UA, et al. Subthalamic stimulation differently modulates declarative and nondeclarative memory[J]. Neuroreport, 2004, 15(3): 539-543.
19. 　Hilker R, Voges J, Weisenbach S, et al. Subthalamic nucleus stimulation restores glucose metabolism in associative and limbic cortices and in cerebellum: evidence from a FDG-PET study in advanced Parkinson’s disease [J]. Cereb Blood Flow Metab, 2004, 24(1): 7-16.
20. 　Witt K, Daniels C, Reiff J, et al. Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s disease: a randomised, multicentre study[J]. Lance Neurol, 2008, 7(7): 605-614.
21. 　Pillon B, Ardouin C, Damier P, et al. Neuropsychological changes between "off" and "on" STN or GPi stimulation in Parkinson’s disease[J]. Neurol, 2000, 55(3): 411-418.
22. 　Smeding HM, Speelman JD, Koning-Haanstra M, et al. Neuropsychological effects of bilateral STN stimulation in Parkinson disease: a controlled study [J]. Neurology, 2006, 66(12): 1830-1836.
23. 　Morrison CE, Borod JC, Perrine K, et al. Neuropsychological functioning following bilateral subthalamic nucleus stimulation in Parkinson’s disease[J]. Arch Clin Neuropsycho, 2004, 19(2): 165-181.
24. 　Uc EY, Rizzo M, Anderson SW, et al. Impaired visual search in drivers with Parkinson’s disease[J]. Ann Neurol, 2006, 60(4): 407-413.
25. 　Halpern CH, Rick JH, Danish SH, et al. Cognition following bilateral deep brain stimulation surgery of the subthalamic nucleus for Parkinson’s disease[J]. Int J Geriatr Psychiatry, 2009, 24(5): 443-451.
26. 　MikJos A, Zahodne L, Okun MS, et al. Cognitive declines after unilateral deep brain stimulation surgery in Parkinson’s disease: a controlled study using reliable change, part II[J]. Clin Neuropsychol, 2010, 24(2): 235-245.
27. 　Appleby BS, Duggan PS, Regenberg A, et al. Psychiatric and neuropsychiatric adverse events associated with deep brain stimulation: a meta-analysis of ten years’experience[J]. Mov Disord, 2007, 22(12): 1722-1728.
28. 　Rektor I, Baláz M, Bocková M, et al. Cognitive activities in the subthalamic nucleus. Invasive studies. [J]. Parkinsonism Relat Disord, 2009, 15(Suppl 3): 83-86.
29. 　Bickel S, Alvarez L, Macias R, et al. Cognitive and neuropsychiatric effects of subthalamotomy for Parkinson’s disease[J]. Parkinsonism Relat Disord, 2010, 16(8): 535-539.
  1. 1. 　Silberstein P, Bittar RG, Boyle R, et al. Deep brain stimulation for Parkinson’s disease: Australian referral guidelines[J]. J Clin Neurosci, 2009, 16(8): 1001-1008.
  2. 2. 　Gaspair DD, Siri C, Gioia MD, et al. Clinical correlates and cognitive underpinnings of verbal fluency impairment after chronic subthalamic stimulation in Parkinson’s disease[J]. Parkinsonism Relat Disord, 2006, 12(5): 289-295.
  3. 3. 　Parsons TD, Rogers SA, Braaten AJ, et al. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: a meta-analysis[J]. Lancet Neurol, 2006, 5(7): 578-588.
  4. 4. 　Funkiewiez A, Ardouin C, Caputo E, et al. Long-term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood and behaviour in Parkinson’s disease[J]. J Neurol Neurosurg Psychiatry, 2004, 75(6): 834-839.
  5. 5. 　Castelli L, Rizzi L, Zibetti M, et al. Neuropsychological changes 1-year after subthalamic DBS in PD patients: A prospective controlled study[J]. Parkinsonism Relat Disord, 2010, 16(2): 115-118.
  6. 6. 　Zangaglia R, Pacchetti C, Pasotti C, et al. Deep brain stimulation and cognitive functions in Parkinson’s disease: a three-year controlled study[J]. Mov Disord, 2009, 24(11): 621-1628.
  7. 7. 　Schroeder U, KuehlerA, Lange KW, et al. Subthalamic nucleus stimulation affects a frontotemporal network: a PET study[J]. Ann Neurol, 2003, 4(4): 445-450.
  8. 8. 　Troster AI, Woods SP, Fields JA, et al. Declines in switching underlie verbal fluency changes after unilateral pallidal surgery in Parkinson’s disease[J]. Brain Cogn, 2002, 50(2): 207-217.
  9. 9. 　Okun MS, Fernandez HH, Wu SS, et al. Cognition and mood in Parkinson’s disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: the compare Trial[J]. Int J Geriatr Psychiatry, 2009, 24: 443-451.
  10. 10. 　Whelan BM, Murdoch BE, Theodoros DG, et al. Beyond verbal fluency: investigating the long-term effects of bilateral subthalamic (STN) deep brain stimulation (DBS) on language function in two cases[J]. Neurocase, 2005, 11(2): 93-102.
  11. 11. 　Fraraccio M, Ptito A, Sadikot A, et al. Absence of cognitive deficits following deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease[J]. Arch Clin Neuropsychol, 2008, 23(4): 399-408.
  12. 12. 　Daniels C, Krack P, Volkmann J, et al. Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson’s disease[J]. Mov Disord, 2010, 25(11): 1583-1589.
  13. 13. 　Balaz M, Rektor I, Pulkrabek J, et al. Participation of the subthalamic nucleus in executive functions: an intracerebral recording study[J]. Mov Disord, 2008, 23(4): 553-557.
  14. 14. 　Contarino MF, Daniele A, Sibilia AH, et al. Cognitive outcome 5 years after bilateral chronic stimulation of subthalamic nucleus in patients with Parkinson’s disease[J]. Neurol Neurosurg Psychiatry, 2007, 78(3): 248-252.
  15. 15. 　Heo JH, Lee KM, Paek SH, et al. The effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) on cognition in Parkinson disease[J]. J Neurol Sci, 2008, 273(1-2): 19-24.
  16. 16. 　Jahanshahi M, Ardouin CM, Brown RG, et al. The impact of deep brain stimulation on executive function in Parkinson’s disease[J]. Brain, 2000, 123 (Pt 6): 1142-154.
  17. 17. 　Hu R, Eskandar E, Williams Z, et al. Role of deep brain stimulation in modulating memory formation and recall[J]. Neurosurg Focus, 2009, 27(1): E3.
  18. 18. 　Hlbig TD, Gruber D, Kopp UA, et al. Subthalamic stimulation differently modulates declarative and nondeclarative memory[J]. Neuroreport, 2004, 15(3): 539-543.
  19. 19. 　Hilker R, Voges J, Weisenbach S, et al. Subthalamic nucleus stimulation restores glucose metabolism in associative and limbic cortices and in cerebellum: evidence from a FDG-PET study in advanced Parkinson’s disease [J]. Cereb Blood Flow Metab, 2004, 24(1): 7-16.
  20. 20. 　Witt K, Daniels C, Reiff J, et al. Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s disease: a randomised, multicentre study[J]. Lance Neurol, 2008, 7(7): 605-614.
  21. 21. 　Pillon B, Ardouin C, Damier P, et al. Neuropsychological changes between "off" and "on" STN or GPi stimulation in Parkinson’s disease[J]. Neurol, 2000, 55(3): 411-418.
  22. 22. 　Smeding HM, Speelman JD, Koning-Haanstra M, et al. Neuropsychological effects of bilateral STN stimulation in Parkinson disease: a controlled study [J]. Neurology, 2006, 66(12): 1830-1836.
  23. 23. 　Morrison CE, Borod JC, Perrine K, et al. Neuropsychological functioning following bilateral subthalamic nucleus stimulation in Parkinson’s disease[J]. Arch Clin Neuropsycho, 2004, 19(2): 165-181.
  24. 24. 　Uc EY, Rizzo M, Anderson SW, et al. Impaired visual search in drivers with Parkinson’s disease[J]. Ann Neurol, 2006, 60(4): 407-413.
  25. 25. 　Halpern CH, Rick JH, Danish SH, et al. Cognition following bilateral deep brain stimulation surgery of the subthalamic nucleus for Parkinson’s disease[J]. Int J Geriatr Psychiatry, 2009, 24(5): 443-451.
  26. 26. 　MikJos A, Zahodne L, Okun MS, et al. Cognitive declines after unilateral deep brain stimulation surgery in Parkinson’s disease: a controlled study using reliable change, part II[J]. Clin Neuropsychol, 2010, 24(2): 235-245.
  27. 27. 　Appleby BS, Duggan PS, Regenberg A, et al. Psychiatric and neuropsychiatric adverse events associated with deep brain stimulation: a meta-analysis of ten years’experience[J]. Mov Disord, 2007, 22(12): 1722-1728.
  28. 28. 　Rektor I, Baláz M, Bocková M, et al. Cognitive activities in the subthalamic nucleus. Invasive studies. [J]. Parkinsonism Relat Disord, 2009, 15(Suppl 3): 83-86.
  29. 29. 　Bickel S, Alvarez L, Macias R, et al. Cognitive and neuropsychiatric effects of subthalamotomy for Parkinson’s disease[J]. Parkinsonism Relat Disord, 2010, 16(8): 535-539.