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Ref: Markser A,et al.
J Neurol2015 Oct; 262(10): 2275-84. doi: 10. 1007/s00415-015-7839-8. Epub 2015 Jul 11.)thysukal nuclear stimulation (STN-DBS) has been widely used in the treatment of Parkinson's disease, but its adverse reactions are not yet completely clearStN-DBS has been reported to cause cognitive decline in patients, affecting patients' attention, execution, language memory and visual spatial perceptionIt is of great value to establish a clinical index that effectively predicts the cognitive decline after DBS surgeryResearch by Markser, of Cologne University Hospital in Germany, which analyzed the relationship between EEG and postoperative cognitive decline in DBS, suggested that eGD scants as a predictive indicator of cognitive function, and the results were published in the October 2015J Neurolthe study included 30 patients with Parkinson's disease (PD) who were operated on STN-DBSPatients were not associated with severe cognitive impairment prior to surgery, with simple mental health tests (MMSE) 24, DemTect 8 or Mattis Dementia Assessment Scale 136 (Table 1)The preoperative EEG changes were evaluated by GTE short scoring and total scoring, and mmSE, DemTect, and Mattis' dementia assessment scale were used to determine postoperative cognitive functionAccording to whether there was cognitive decline after surgery, the PD-cd group with cognitive decline and the PD-cd group without cognitive decline were analyzed with logistic regression model to analyze the risk factors associated with postoperative cognitive declineTable 1General characteristics of the patient prior to surgerystatistical analysis of data found that 30 patients after STN-DBS, motor dysfunction improved significantly, and the equivalent dose of l-dopa decreased significantly, indicating that STN-DBS on Parkinson's disease symptoms of good resultsHowever, the short and overall GTE scores for the 2-12 month period after surgery were significantly higher than before surgery in all patients (Table 2) Table 2 Clinical performance assessment results and EEG scores for patients before and after surgery UPDRS: Unified Parkinson's Disease Assessment Scale; OFF: Drug "Off" Period; ON/ON: Electrostimulation and Drug "On" Period; MMSE: Simple Mental Condition Check Sheet; GTE: EEGraphic Total Score; FU-1: 2 weeks-3 months after surgery; FU-2: 4-12 months after surgery; p: statistical analysis results of matching data and tests a There were 26 patients with EEG tests during FU-1 follow-up, significant differences in results between preoperative and FU-1 follow-up, and significant differences between preoperative and FU-2 follow-up during the 4-12 month follow-up period after surgery, 6 patients experienced new cognitive decline (PD-cd group) and the remaining 24 cases did not detect cognitive impairment (PD-cd group) Further analysis found that the preoperative GTE scores of the six patients were significantly higher than those of the other 24 patients (Figure 1), and there was no statistical difference in electrode position, brain atrophy, LEED and other motor function scores between the two groups Logistic regression analysis showed that the high preoperative GTE score was a predictive indicator of cognitive decline after surgery (OR, 2.8, 95% CI1.3-6.2) Figure 1 The total GTE score and gtE short score before and after surgery were performed by the two groups of patients GTE-short: GTE Short Score (first 3 items on GTE scoring table) ;postoperativeFU-2: 4-12 months after surgery the authors believe that high GTE scores in patients with normal preoperative cognitive function indicate a higher likelihood of cognitive decline after STN-DBS surgery Because GTE scoring can be done with the naked eye, the authors recommend eEG before STN-DBS surgery, and judge the high-risk population of postoperative cognitive decline of STN-DBS according to gtE score, which is of guiding value to clinical treatment (The Ding Chenxuan, the first hospital affiliated with Fujian Medical University, compiled , Dr Xu Tao , of Shanghai Long March Hospital, the editor-in-chief of The Outside Information, the Ofcheng , a subsidiary of Fudan University), review the effects of deep-brain electrostimulation on pregnancy and childbirth
Forward-looking research on fibrosis imaging in deep brain electro stimulation (DBS) more information please follow the external information WeChat public number: neurosurgerynews.