Clinical Effects On Cognition,Depression And Anxiety Of The Deep Brain Stimulation For Parkinson's Disease

Objective:The non-motor symptoms,such as cognition,depression and anxiety,are common in parkinson,s disease(PD)and adversely affects quality of life.The bilateral subthalamic nucleus deep brain stimulation(STN-DBS)effecttively treat the motor symptoms of PD,but questions remains regarding the impact of bilateral STN-DBS on cognition,depression and anxiety.Methods:In this trial,we enrolled 16 PD patients who underwent bilateral STN-DBS,the primary end points were the changes from base to 1 months and 3 months in the cognition,depression and anxiety.Cognition was assessed using the Mini Mental State Examination(MMSE),and Montreal Cognitive Assessment(MoCA),depression and anxiety was assessed using Hamilton Depression Rating Scale-17(HAMD-17),Hamilton Anxiety Rating Scale(HAMA)respectively.Participants were also evaluated with UPDRS part ?,and UPDRS part ?.As a control,we also evaluated changes in MMSE,MoCA,HAMD and HAMA in 16 PD patients who were optimized for drug treatment.Results:Participants with bilateral STN-DBS show a decrease in cognition 1 months(MMSE:24.06±4.81,MoCA:19.81 ± 4.34)and 3 months(MMSE:25.19±3.85,MoCA:19.44 ± 5.35)post-operatively compared to preoperative baseline(MMSE:24.81±4.61,MoCA:20.69 ± 4.33),but the difference was not statisticallysignificant.(P<0.05);Compared with preoperative,the delayed recall of PD patients in the STN-DBS group improved at 3 months after surgery.Participants with bilateral STN-DBS experienced significant improvement in depression and anxiety 1 months(HAMD-17:11.94 ± 6.16)and 3 months(HAMD-17:7.38 ± 5.18)post-operatively compared to preoperative baseline(HAMD-17:23.56 ± 14.60).And compared with preoperative period(HAMA:22.13 ± 6.11),the anxiety of PD patients with bilateral STN-DBS was significantly improved after 1 months(HAMA:15.13 ± 5.62)and 3months(HAMA:8.00 ± 6.76)post-operatively.But HAMD-17,HAMA scores did not correlate with UPDRS part ? at any time point.Participants without DBS experienced no significant change in MMSE,MoCA,HAMD-17 and HAMA over the same interval.Conclusion:Bilateral STN-DBS do not affect the global cognitive function 3 months post-operatively in PD patients,and the delayed recall was improved in 3 months post-operatively.And bilateral STN-DBS can significantly improved depression and anxiety in 1 and 3 months post-operatively;The improvement of depression and anxiety was not correlated with the improvement of motor symptoms at any time points.