影响 DBS 对与帕金森病相关的睡眠和抑郁障碍疗效的代谢风险因素的转化评估:临床前、前瞻性和队列研究。

IF 12.5 2区 医学 Q1 SURGERY International journal of surgery Pub Date : 2024-09-06 DOI:10.1097/JS9.0000000000002081
Longping Yao, Rui Chen, Zijian Zheng, Maryam Hatami, Sumeyye Koc, Xu Wang, Yang Bai, Chen Yao, Guohui Lu, Thomas Skutella
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引用次数: 0

摘要

背景:帕金森病(PD)与代谢风险因素有关,包括体重指数(BMI)、空腹血糖(FBG)、胆固醇水平和甘油三酯(TG)。这些因素对帕金森病患者的运动症状、抑郁和睡眠问题有多大影响,以及它们在决定脑深部刺激(DBS)疗法成功与否方面的作用,目前尚不完全清楚:本研究通过小鼠模型和人类受试者,深入研究了BMI、FBG、胆固醇和TG等代谢风险因素对DBS治疗PD相关抑郁和睡眠障碍效果的影响:结果:DBS明显改善了帕金森病小鼠和患者的抑郁和睡眠障碍。高糖高脂饮食会加重 MPTP 诱导的小鼠抑郁和睡眠障碍。伴有抑郁和睡眠障碍的帕金森病患者的体重指数(BMI)、血脂、血胆固醇和总胆固醇指标都有所升高。值得注意的是,这些指标对 DBS 改善抑郁和睡眠问题的效率有相当大的不利影响,但对运动症状却没有影响。DBS 的有利影响持续了约 6 年,之后出现了显著下降。重要的是,我们从小鼠对照组和患者队列中获得的转化证据表明,降血糖和降血脂疗法增强了DBS在减轻与帕金森病相关的抑郁和睡眠障碍方面的疗效,而不会影响患者的运动功能:总之,这项研究强调,DBS 是治疗帕金森病抑郁和睡眠问题的有效方法,其成功与否受代谢风险因素的影响。研究进一步表明,结合高血糖和高胆固醇治疗可提高 DBS 治疗帕金森病抑郁和睡眠障碍的疗效,同时不会影响患者的运动症状。
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Translational evaluation of metabolic risk factors impacting DBS efficacy for PD-Related sleep and depressive disorders: preclinical, prospective and cohort studies.

Background: Parkinson's disease (PD) is linked with metabolic risk factors including body mass index (BMI), fasting blood glucose (FBG), cholesterol levels, and triglycerides (TG). The extent to which these factors affect motor symptoms, depression, and sleep problems in PD, as well as their role in determining the success of deep brain stimulation (DBS) therapy, is yet to be fully understood.

Methods: This study delved into the effects of metabolic risk factors like BMI, FBG, cholesterol, and TG on the outcomes of DBS in treating PD-related depression and sleep disturbances, across both mouse models and human subjects.

Results: DBS showcased noticeable betterment in depression and sleep perturbations in both PD-afflicted mice and patients. High-sugar-high-fat diet aggravates MPTP-induced depression and sleep disorders in mice. PD-afflicted individuals presenting with depressive and sleep disorders demonstrated elevated metrics of BMI, FBG, blood cholesterol, and TG. Remarkably, these metrics bore considerable adverse influences on the efficiency of DBS in ameliorating depression and sleep issues, yet spared motor symptoms. The favorable impacts of DBS persisted for approximately 6 years, post which a significant decline was noted. Importantly, our translational evidence from both murine controls and patient cohorts indicated that antihyperglycemic and antihyperlipidemic therapies bolstered the efficacy of DBS in mitigating PD-related depression and sleep disturbances, without impinging upon motor functions in patients.

Conclusion: In summary, this research emphasizes that DBS is a powerful treatment option for depression and sleep issues in PD, with its success influenced by metabolic risk factors. It further suggests that incorporating treatments for high blood sugar and cholesterol can enhance the efficacy of DBS in treating depression and sleep disturbances in PD, without impacting motor symptoms, highlighting the importance of metabolic risk management in PD patients receiving DBS.

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来源期刊
CiteScore
17.70
自引率
3.30%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.
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