帕金森病患者接受深部脑刺激后认知变化的预测进展。

IF 3.4 2区 医学 Q2 CLINICAL NEUROLOGY Expert Review of Neurotherapeutics Pub Date : 2024-07-01 Epub Date: 2024-05-30 DOI:10.1080/14737175.2024.2360121
Alexander I Tröster
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引用次数: 0

摘要

简介:脑深部刺激(DBS)是治疗帕金森病(PD)运动症状的一种有效方法,可改善经适当选择的患者的功能和生活质量。由于少数患者在接受 DBS 治疗后可能会出现轻度至中度认知功能下降并影响生活质量,因此认知功能障碍及其预测是一个重要的考虑因素:作者简要总结了DBS的认知结果,并通过主要关注2018年至2024年间发表的、使用综合神经心理学(NP)评估的研究,更详细地回顾了DBS后认知功能障碍的风险/预测因素。大多数出版物涉及双侧丘脑下核(STN)DBS。专家意见:STN DBS 在认知方面相对安全,但会出现下降,尤其是在言语流畅性和执行功能/工作记忆方面。认知结果的许多预测因素和风险因素已被确定(年龄和术前神经心理状态似乎是最可靠的因素),但目前还不能有把握地提供精确的风险估计值。未来的研究应采用研究中心联盟,遵循统一的报告标准(有待制定),利用刺激、生物标志物和人工智能方面的进步,并针对不同群体进行 DBS 研究。研究进展为利用神经调控改善帕金森病认知障碍提供了一条途径。
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Developments in the prediction of cognitive changes following deep brain stimulation in persons with Parkinson's disease.

Introduction: Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD) motor symptoms that improves function and quality of life in appropriately selected patients. Because mild to moderate cognitive declines can follow DBS and impact quality of life in a minority of patients, an important consideration involves the cognitive deficit and its prediction.

Areas covered: The author briefly summarizes cognitive outcomes from DBS and reviews in more detail the risks/predictors of post-DBS cognitive dysfunction by mainly focusing on work published between 2018 and 2024 and using comprehensive neuropsychological (NP) evaluations. Most publications concern bilateral subthalamic nucleus (STN) DBS. Comment is offered on challenges and potential avenues forward.

Expert opinion: STN DBS is relatively safe cognitively but declines occur especially in verbal fluency and executive function/working memory. Numerous predictors and risk factors for cognitive outcomes have been identified (age and pre-operative neuropsychological status appear the most robust) but precise risk estimates cannot yet be confidently offered. Future studies should employ study center consortia, follow uniform reporting criteria (to be developed), capitalize on advances in stimulation, biomarkers, and artificial intelligence, and address DBS in diverse groups. Advances offer an avenue to investigate the amelioration of cognitive deficits in PD using neuromodulation.

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来源期刊
Expert Review of Neurotherapeutics
Expert Review of Neurotherapeutics Medicine-Neurology (clinical)
CiteScore
7.00
自引率
2.30%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Expert Review of Neurotherapeutics (ISSN 1473-7175) provides expert reviews on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer''s and Parkinson''s. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points
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