丘脑底核脑深部电刺激术对帕金森病合并抑郁影响的研究进展

doi:10.3969/j.issn.1674-8115.2021.06.019

摘要/Abstract

摘要：

抑郁是帕金森病（Parkinson's disease，PD）常见的非运动症状，是PD患者生活质量下降的重要因素。丘脑底核脑深部电刺激（subthalamic nucleus deep brain stimulation，STN-DBS）对PD运动症状疗效明确，而对PD患者抑郁情绪的影响尚无定论。该文从PD合并抑郁的流行病学特征及发病机制、STN-DBS对PD合并抑郁的影响机制、STN-DBS对PD合并抑郁影响的影像学及电生理研究、DBS术后药物调整对PD合并抑郁的影响，以及电极位置对PD患者情绪的影响等方面作一综述。

关键词: 帕金森病, 抑郁, 丘脑底核, 脑深部电刺激术

Abstract:

Depression is a common non-motor symptom of Parkinson′s disease (PD) and is a critical factor in the reduction of life quality of PD patients. The therapeutic effect of subthalamic nucleus deep brain stimulation (STN-DBS) on PD motor symptoms has been well documented. However, their effect on the related depression in PD is inconclusive. This article reviews the epidemiological characteristics and pathogenesis of PD and its related depression, the mechanism underlying the effects of STN-DBS on PD-related depression, the imaging and electrophysiological research of STN-DBS on PD and its related depression, the effects of STN-DBS on drug use, and the effects of electrode position on emotion.

Key words: Parkinson′s disease (PD), depression, subthalamic nucleus, deep brain stimulation

中图分类号:

R742.5

张小小, 张陈诚, 赖伊杰, 孙伯民. 丘脑底核脑深部电刺激术对帕金森病合并抑郁影响的研究进展[J]. 上海交通大学学报(医学版), 2021, 41(6): 815-820.

Xiao-xiao ZHANG, Chen-cheng ZHANG, Yi-jie LAI, Bo-min SUN. Recent progresses in deep brain stimulation of subthalamic nucleus on Parkinson′s disease and its related depression[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(6): 815-820.

参考文献 64

1	Armstrong MJ, Okun MS. Diagnosis and treatment of parkinson disease: a review[J]. JAMA, 2020, 323(6): 548-560.
2	Dobkin RD, Menza M, Allen LA, et al. Cognitive-behavioral therapy for depression in Parkinson's disease: a randomized, controlled trial[J]. Am J Psychiatry, 2011, 168(10): 1066-1074.
3	Luquin MR, Kulisevsky J, Martinez-Martin P, et al. Consensus on the definition of advanced Parkinson's disease: a neurologists-based Delphi study (CEPA study)[J]. Parkinsons Dis, 2017, 2017: 4047392.
4	Kuhlman GD, Flanigan JL, Sperling SA, et al. Predictors of health-related quality of life in Parkinson's disease[J]. Park Relat Disord, 2019, 65: 86-90.
5	Kleiner-Fisman G, Herzog J, Fisman DN, et al. Subthalamic nucleus deep brain stimulation: summary and meta-analysis of outcomes[J]. Mov Disord, 2006, 21(): S290-S304.
6	Combs HL, Folley BS, Berry DT, et al. Cognition and depression following deep brain stimulation of the subthalamic nucleus and globus pallidus pars internus in Parkinson's disease: a meta-analysis[J]. Neuropsychol Rev, 2015, 25(4): 439-454.
7	Abbes M, Lhommée E, Thobois S, et al. Subthalamic stimulation and neuropsychiatric symptoms in Parkinson's disease: results from a long-term follow-up cohort study[J]. J Neurol Neurosurg Psychiatry, 2018, 89(8): 836-843.
8	Lhommée E, Klinger H, Thobois S, et al. Subthalamic stimulation in Parkinson's disease: restoring the balance of motivated behaviours[J]. Brain, 2012, 135(Pt 5): 1463-1477.
9	Lilleeng B, Gjerstad M, Baardsen R, et al. The long-term development of non-motor problems after STN-DBS[J]. Acta Neurol Scand, 2015, 132(4): 251-258.
10	Reijnders JS, Ehrt U, Weber WE, et al. A systematic review of prevalence studies of depression in Parkinson's disease[J]. Mov Disord, 2008, 23(2): 183-189;quiz313.
11	Chagas MH, Moriyama TS, Felício AC, et al. Depression increases in patients with Parkinson's disease according to the increasing severity of the cognitive impairment[J]. Arq Neuropsiquiatr, 2014, 72(6): 426-429.
12	Shen CC, Tsai SJ, Perng CL, et al. Risk of Parkinson disease after depression: a nationwide population-based study[J]. Neurology, 2013, 81(17): 1538-1544.
13	Mayberg HS, Solomon DH. Depression in Parkinson's disease: a biochemical and organic viewpoint[J]. Adv Neurol, 1995, 65: 49-60.
14	Ossowska K, Lorenc-Koci E. Depression in Parkinson's disease[J]. Pharmacol Rep, 2013, 65(6): 1545-1557.
15	Arabia G, Grossardt BR, Geda YE, et al. Increased risk of depressive and anxiety disorders in relatives of patients with Parkinson disease[J]. Arch Gen Psychiatry, 2007, 64(12): 1385-1392.
16	Wang JY, Fan QY, He JH, et al. SLC6A4 repeat and single-nucleotide polymorphisms are associated with depression and rest tremor in Parkinson's disease: an exploratory study[J]. Front Neurol, 2019, 10: 333.
17	Meloni M, Puligheddu M, Carta M, et al. Efficacy and safety of 5-hydroxytryptophan on depression and apathy in Parkinson's disease: a preliminary finding[J]. Eur J Neurol, 2020, 27(5): 779-786.
18	Braak H, Ghebremedhin E, Rüb U, et al. Stages in the development of Parkinson's disease-related pathology[J]. Cell Tissue Res, 2004, 318(1): 121-134.
19	Kostić VS, Agosta F, Petrović I, et al. Regional patterns of brain tissue loss associated with depression in Parkinson disease[J]. Neurology, 2010, 75(10): 857-863.
20	Aarsland D, Påhlhagen S, Ballard CG, et al. Depression in Parkinson disease: epidemiology, mechanisms and management[J]. Nat Rev Neurol, 2011, 8(1): 35-47.
21	Odekerken VJ, van Laar T, Staal MJ, et al. Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson's disease (NSTAPS study): a randomised controlled trial[J]. Lancet Neurol, 2013, 12(1): 37-44.
22	Zhou HY, Wang LB, Zhang CC, et al. Acute effects of subthalamic deep brain stimulation on motor outcomes in Parkinson's disease; 13 year follow up[J]. Front Neurol, 2019, 10: 689.
23	Chopra A, Abulseoud OA, Sampson S, et al. Mood stability in Parkinson disease following deep brain stimulation: a 6-month prospective follow-up study[J]. Psychosomatics, 2014, 55(5): 478-484.
24	Funkiewiez A, Ardouin C, Caputo E, et al. Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson's disease[J]. J Neurol Neurosurg Psychiatry, 2004, 75(6): 834-839.
25	McDonald LM, Page D, Wilkinson L, et al. Deep brain stimulation of the subthalamic nucleus improves sense of well-being in Parkinson's disease[J]. Mov Disord, 2012, 27(3): 372-378.
26	Fabbri M, Coelho M, Guedes LC, et al. Acute response of non-motor symptoms to subthalamic deep brain stimulation in Parkinson's disease[J]. Parkinsonism Relat Disord, 2017, 41: 113-117.
27	Bejjani BP, Damier P, Arnulf I, et al. Transient acute depression induced by high-frequency deep-brain stimulation[J]. N Engl J Med, 1999, 340(19): 1476-1480.
28	Doshi PK, Chhaya N, Bhatt MH. Depression leading to attempted suicide after bilateral subthalamic nucleus stimulation for Parkinson's disease[J]. Mov Disord, 2002, 17(5): 1084-1085.
29	Okun MS, Fernandez HH, Wu SS, et al. Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: the COMPARE trial[J]. Ann Neurol, 2009, 65(5): 586-595.
30	Follett KA, Weaver FM, Stern M, et al. Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease[J]. N Engl J Med, 2010, 362(22): 2077-2091.
31	Berney A, Vingerhoets F, Perrin A, et al. Effect on mood of subthalamic DBS for Parkinson's disease: a consecutive series of 24 patients[J]. Neurology, 2002, 59(9): 1427-1429.
32	Houeto JL, Mesnage V, Mallet L, et al. Behavioural disorders, Parkinson's disease and subthalamic stimulation[J]. J Neurol Neurosurg Psychiatry, 2002, 72(6): 701-707.
33	Strutt AM, Simpson R, Jankovic J, et al. Changes in cognitive-emotional and physiological symptoms of depression following STN-DBS for the treatment of Parkinson's disease[J]. Eur J Neurol, 2012, 19(1): 121-127.
34	Petersson P, Halje P, Cenci MA. Significance and translational value of high-frequency cortico-basal Ganglia oscillations in Parkinson's disease[J]. J Parkinsons Dis, 2019, 9(1): 183-196.
35	Karachi C, Yelnik J, Tandé D, et al. The pallidosubthalamic projection: an anatomical substrate for nonmotor functions of the subthalamic nucleus in Primates[J]. Mov Disord, 2005, 20(2): 172-180.
36	Hilker R, Voges J, Weisenbach S, et al. Subthalamic nucleus stimulation restores glucose metabolism in associative and limbic cortices and in cerebellum: evidence from a FDG-PET study in advanced Parkinson's disease[J]. J Cereb Blood Flow Metab, 2004, 24(1): 7-16.
37	Temel Y, Blokland A, Steinbusch HW, et al. The functional role of the subthalamic nucleus in cognitive and limbic circuits[J]. Prog Neurobiol, 2005, 76(6): 393-413.
38	Rodriguez-Oroz MC, Gorospe A, Guridi J, et al. Bilateral deep brain stimulation of the subthalamic nucleus in Parkinson's disease[J]. Neurology, 2000, 55(12 ): S45-S51.
39	Kim HJ, Jeon BS, Paek SH. Nonmotor symptoms and subthalamic deep brain stimulation in Parkinson's disease[J]. J Mov Disord, 2015, 8(2): 83-91.
40	Politis M, Wu K, Loane C, et al. Staging of serotonergic dysfunction in Parkinson's disease: an in vivo 11C-DASB PET study[J]. Neurobiol Dis, 2010, 40(1): 216-221.
41	Tan SK, Hartung H, Sharp T, et al. Serotonin-dependent depression in Parkinson's disease: a role for the subthalamic nucleus?[J]. Neuropharmacology, 2011, 61(3): 387-399.
42	Navailles S, Benazzouz A, Bioulac B, et al. High-frequency stimulation of the subthalamic nucleus and L-3, 4-dihydroxyphenylalanine inhibit in vivo serotonin release in the prefrontal cortex and Hippocampus in a rat model of Parkinson's disease[J]. J Neurosci, 2010, 30(6): 2356-2364.
43	Stefani A, Cerroni R, Mazzone P, et al. Mechanisms of action underlying the efficacy of deep brain stimulation of the subthalamic nucleus in Parkinson's disease: central role of disease severity[J]. Eur J Neurosci, 2019, 49(6): 805-816.
44	Kumar R, Lozano AM, Sime E, et al. Comparative effects of unilateral and bilateral subthalamic nucleus deep brain stimulation[J]. Neurology, 1999, 53(3): 561-566.
45	Cummings JL. Frontal-subcortical circuits and human behavior[J]. Arch Neurol, 1993, 50(8): 873-880.
46	Klauser P, Fornito A, Lorenzetti V, et al. Cortico-limbic network abnormalities in individuals with current and past major depressive disorder[J]. J Affect Disord, 2015, 173: 45-52.
47	Feldmann A, Illes Z, Kosztolanyi P, et al. Morphometric changes of gray matter in Parkinson's disease with depression: a voxel-based morphometry study[J]. Mov Disord, 2008, 23(1): 42-46.
48	Cardoso EF, Maia FM, Fregni F, et al. Depression in Parkinson's disease: convergence from voxel-based morphometry and functional magnetic resonance imaging in the limbic thalamus[J]. Neuroimage, 2009, 47(2): 467-472.
49	Jeune F, Péron J, Grandjean D, et al. Subthalamic nucleus stimulation affects limbic and associative circuits: a PET study[J]. Eur J Nucl Med Mol Imaging, 2010, 37(8): 1512-1520.
50	Kalbe E, Voges J, Weber T, et al. Frontal FDG-PET activity correlates with cognitive outcome after STN-DBS in Parkinson disease[J]. Neurology, 2009, 72(1): 42-49.
51	Langner-Lemercier S, Drapier S, Naudet F, et al. Preoperative brain metabolism and quality of life after subthalamic nucleus stimulation in Parkinson's disease[J]. J Neurol, 2015, 262(4): 881-889.
52	Rappel P, Grosberg S, Arkadir D, et al. Theta-alpha oscillations characterize emotional subregion in the human ventral subthalamic nucleus[J]. Mov Disord, 2020, 35(2): 337-343.
53	Kühn AA, Hariz MI, Silberstein P, et al. Activation of the subthalamic region during emotional processing in Parkinson disease[J]. Neurology, 2005, 65(5): 707-713.
54	Thobois S, Ardouin C, Lhommée E, et al. Non-motor dopamine withdrawal syndrome after surgery for Parkinson's disease: predictors and underlying mesolimbic denervation[J]. Brain, 2010, 133(Pt 4): 1111-1127.
55	Voon V, Krack P, Lang AE, et al. A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease[J]. Brain, 2008, 131(Pt 10): 2720-2728.
56	Alexoudi A, Shalash A, Knudsen K, et al. The medical treatment of patients with Parkinson's disease receiving subthalamic neurostimulation[J]. Parkinsonism Relat Disord, 2015, 21(6): 555-560.
57	Zibetti M, Cinquepalmi A, Angrisano S, et al. Management of antiparkinsonian therapy during chronic subthalamic stimulation in Parkinson's disease[J]. Parkinsonism Relat Disord, 2009, 15(): S76-S80.
58	Yu XX, Fernandez HH. Dopamine agonist withdrawal syndrome: a comprehensive review[J]. J Neurol Sci, 2017, 374: 53-55.
59	Brunenberg EJ, Moeskops P, Backes WH, et al. Structural and resting state functional connectivity of the subthalamic nucleus: identification of motor STN parts and the hyperdirect pathway[J]. PLoS One, 2012, 7(6): e39061.
60	Dafsari HS, Petry-Schmelzer JN, Ray-Chaudhuri K, et al. Non-motor outcomes of subthalamic stimulation in Parkinson's disease depend on location of active contacts[J]. Brain Stimul, 2018, 11(4): 904-912.
61	Krack P, Hariz MI, Baunez C, et al. Deep brain stimulation: from neurology to psychiatry?[J]. Trends Neurosci, 2010, 33(10): 474-484.
62	Blomstedt P, Hariz MI, Lees A, et al. Acute severe depression induced by intraoperative stimulation of the substantia nigra: a case report[J]. Parkinsonism Relat Disord, 2008, 14(3): 253-256.
63	Starkstein SE, Brockman S. Management of depression in Parkinson's disease: a systematic review[J]. Mov Disord Clin Pract, 2017, 4(4): 470-477.
64	苗海锋, 马荣, 吴志强, 等. 帕罗西汀治疗帕金森病伴发抑郁障碍临床疗效与安全性分析[J]. 中国实用神经疾病杂志, 2014, 17(4): 9-12.

[1]	袁笑, 田野野, 薛峥. 6-OHDA诱导的帕金森病小鼠表现出以p16^Ink4a上调和星形胶质细胞衰老为特征的衰老表型[J]. 上海交通大学学报(医学版), 2021, 41(7): 876-883.
[2]	耿瑞杰, 姚琳, 黄欣欣, 禹顺英, 苑成梅, 洪武, 吕钦谕, 王庆中, 易正辉, 方贻儒. 基于加权基因共表达网络分析识别抑郁症的差异表达基因模块[J]. 上海交通大学学报(医学版), 2021, 41(6): 724-731.
[3]	汤叶舟，史一凡，黄雨欣，赵雅娟，符浩，黄佳，王勇. 伴不同程度焦虑的抑郁障碍患者睡眠质量与特征分析[J]. 上海交通大学学报（医学版）, 2020, 40(3): 333-.
[4]	文万军1，陈晔1，覃宗厚1，吕望强2，唐伟3，卢卫红4，范卫星2，张晨4. 血清白介素-6水平与精神分裂症伴抑郁症状之间的关系[J]. 上海交通大学学报(医学版), 2020, 40(12): 1618-1620.
[5]	赵俊雄1，华深1，范卫星1，王卫平1，唐伟2，张晨1, 3. SIRT1基因与抑郁症及其临床表型的关联研究[J]. 上海交通大学学报（医学版）, 2020, 40(1): 18-.
[6]	金志兴1，王媺媞1，周千1#，吕洞宾1，王凡1，黄秦特1，吴政霖1，李海滨1，徐初琛1，曹岚1，赵杰2，曹彤丹2，黄海婧1，方贻儒1，洪武1#. 睡眠呼吸暂停综合征延长双相障碍患者抑郁相的快速眼动睡眠时间并缩短躁狂相的熟睡时间[J]. 上海交通大学学报（医学版）, 2020, 40(1): 51-.
[7]	王滔1，张陈诚1，李殿友1，孙伯民1，傅萌2. 帕金森病脑深部电刺激电极术后位置规律分析[J]. 上海交通大学学报（医学版）, 2020, 40(1): 64-.
[8]	林青青，仇剑崟. 抑郁症患者的社会和人际功能障碍[J]. 上海交通大学学报(医学版), 2020, 40(07): 985-989.
[9]	程佳月，李璞玉，顾秋梦，王佩，陈珏，刘强#，王振#. 强迫症患者的强迫症状在归因方式与抑郁症状间的中介作用[J]. 上海交通大学学报(医学版), 2020, 40(06): 785-790.
[10]	郭垒1，胡嫣然1, 2，亢清1，王钰萍1，王振1，陈涵1#，陈珏1#. 神经性厌食患者应激负性感受和体象关注的关系：抑郁症状的中介作用[J]. 上海交通大学学报(医学版), 2020, 40(06): 798-803.
[11]	彭毅华1，黄烨2，聂磊嬿1，刘强1#，陈珏1#. 自评家庭负担量表应用于神经性厌食患者家庭的信效度研究[J]. 上海交通大学学报(医学版), 2020, 40(06): 804-808.
[12]	钱时兴，房圆#，孙琳，仇琦，林治光，肖世富，李霞#. 西酞普兰对抑郁症患者外周血miRNA-16/5- 羟色胺转运体通路的影响[J]. 上海交通大学学报(医学版), 2020, 40(06): 814-819.
[13]	倪雪萍1, 2，李贤华2，忻笑2，吴圣佳1, 2，宋婷1，赫洋2，郑欣2. 非霍奇金淋巴瘤患者自我感受负担现状及相关因素分析[J]. 上海交通大学学报(医学版), 2020, 40(06): 856-862.
[14]	张丽1，方芳1，朱智佩2, 3，申远4，柳娜5，李春波3. 简化认知行为治疗对广泛性焦虑的疗效研究[J]. 上海交通大学学报(医学版), 2020, 40(05): 619-625.
[15]	叶惠玲，吕娜，范青. 抑郁症语义加工异常脑机制研究进展[J]. 上海交通大学学报(医学版), 2020, 40(05): 679-682.