| Objective:To explore and discuss the effect of deep brain stimulation(DBS)on anxiety,depression and cognitive function in patients with Parkinson's disease(PD)Methods:15 PD patients who were treated with STN-DBS in our hospital from January 2019 to August 2019 were continuously collected as the DBS operation group.The Montreal Cognitive Assessment(MoCA),Wechsler Memory Scale(WMS),Hamilton Anxiety Scale(HAMA),Hamilton Depression Rating Scale for Expression,HAMD,Unified Parkinson Disease Rating Scale(UPDRS ?,?),H&Y Rating Scale(Hoehn Yahr)Grading,H&Y)were used to evaluate the patients' cognitive function,memory,anxiety,depression,activity of daily living,motor function and disease severity in 1 week before operation,1 month after operation,6 months after operation and 3 months after operation respectively.29 matched PD patients who were treated with PD drugs in outpatient or inpatient department of our hospital were collected as the drug treatment group,and these patients were evaluated with the same scale as operation group at the same time point.Results:1.There was no significant difference in the total score of MOCA and WMS between the two groups(P>0.05).In the cognitive fields of Moca,the attention of DBS group decreased significantly(P<0.05)compared with drug group and Preoperation at the time of start-up and 1 month after operation,and gradually recovered at the time of 3 and 6 months after operation,but there was no significant difference between groups and within groups(P>0.05).Among the memory sub items of WMS,the picture recall of DBS operation group decreased significantly(P<0.05)compared with that of drug group and before operation,recovered at 1 month after operation,and remained stable at 3 and 6 months after operation,but there was no significant difference between groups and within groups(P>0.05).There was no significant difference in other sub items between groups and within groups at each time node(P>0.05).2.In DBS group,there was no significant difference between the anxiety score of the first week after operation and that of the first week before operation(P>0.05),but the anxiety score of the first month after operation was significantly improved compared with that of the first week before operation and continued to improve to the sixth month after operation(P<0.05).In addition,the anxiety score of the sixth month after operation was significantly improved compared with that of the third month after operation(P<0.05).The anxiety scores of the drug treatment group were improved,but there was no significant difference in the scores of each time point(P>0.05).3.In DBS group,there was no significant difference between the depression score of one week before and after operation(P>0.05),but the depression score of one month after operation was significantly improved compared with that of one week before operation and lasted until six months after operation(P<0.05).The depression scores of the drug treatment group were improved,but there was no statistical significance at all time points(P>0.05)4.Compared with 1 week before operation,the activities of daily living and motor function of DBS group were significantly improved after operation,1 month,3 months and 6 months after operation(P<0.05).5.The anxiety of DBS group was significantly correlated with the ability of daily living and exercise(P<0.05),and the improvement of postoperative anxiety was significantly correlated with the improvement of exercise ability(P<0.05);preoperative depression was significantly correlated with exercise ability(P<0.05);the total score of WMS was negatively correlated with exercise ability(P<0.05)at the time of start-up;and the changes of postoperative depression and overall cognition were negatively correlated with UPDRS There was no correlation between II and III(P>0.05).Conclusions:1.Some cognitive areas of PD patients,such as attention and short-term memory(picture regeneration),decreased in the short term after DBS compared with PD drug treatment group.However,with the continuous adjustment of stimulation parameters to achieve the best effect,these cognitive areas will recover and tend to be stable within half a year after surgery,and bilateral STN-DBS does not affect the overall cognitive situation of PD patients.2.The changes of short-term memory after DBS may be related to the severity of motor symptoms.3.After bilateral STN-DBS,anxiety and depression of PD patients were improved within half a year,and the improvement of anxiety was related to the improvement of motor symptoms.The anxiety and depression of PD patients will be improved after PD drug treatment,but the improvement is not obvious4.The activity of daily living and motor function of patients with PD were significantly improved within half a year after DBS.Therefore,DBS is effective in the treatment of motor symptoms of patients with PD,which is consistent with the previous research results. |
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