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目的研究丘脑底核(STN)脑深部电刺激(DBS)治疗帕金森病(PD)合并抑郁障碍的长期疗效并探讨其神经机制。方法对15例合并抑郁障碍的PD患者实施STN脑深部电极植入,术后3个月、6个月和12个月进行随访和临床评价。结果术后运动功能症状如肢体僵硬、震颤、运动迟缓和姿势平衡障碍改善良好,停药后PD分级量表运动评分显著下降(P<0.01)。术后抑郁障碍症状如焦虑、绝望和激越症状改善良好,停药后汉密尔顿抑郁量表评分显著下降(P<0.05)。结论STN-DBS能显著改善PD的抑郁障碍症状,STN在PD抑郁障碍神经机制中起重要作用。
Objective To investigate the long-term effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on Parkinson’s disease (PD) with depression and to explore its neural mechanism. Methods Fifteen patients with PD with depressive disorder underwent deep brain electrode implantation of STN. The patients were followed up and evaluated at 3, 6 and 12 months after operation. Results Postoperative motor function symptoms such as limb stiffness, tremor, bradykinesia and posture balance disorders improved well. After PD, the motor score of PD grading scale decreased significantly (P <0.01). Postoperative depression symptoms such as anxiety, despair and agitation improved well, and the Hamilton Depression Scale score decreased significantly after stopping treatment (P <0.05). Conclusion STN-DBS can significantly improve the symptoms of depression in PD, STN plays an important role in the neural mechanism of PD depression.