Abstract：
OBJECTIVE: Parkinson\'s disease (PD) as a neurodegenerative disorder characterized by a reduction in both the quantity and functionality of dopaminergic neurons. This succinctly highlights the central pathological feature of PD and its association with dopaminergic neuron degeneration, which underlies the motor and non-motor symptoms of the disease. This study aims to elucidate the nuances of apparent diffusion coefficient (ADC) changes in different cerebral regions by after the bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) surgery of PD, as well as to investigate their potential interactions with the motor and neuropsychiatric spectrum.
METHODS: Patients who underwent STN-DBS surgery for PD between 2017 and 2019 were included in this study. The results of diffusion magnetic resonance imaging (MRI), Unified Parkinson Disease Rating Scale (UPDRS) III scores, Beck and Hamilton depression tests were recorded before and at the 3rd month of postoperative stimulation. The data obtained were evaluated with the Wilcoxon signed rank test. Result of the statistical tests were within the 95 % confidence interval and p values were significant below 0.05.
RESULTS: Our study was conducted with a total of 13 patients, 8 men and 5 women. As a result of measurements made in a total of 32 different regions, especially in the motor and neuropsychiatric areas of the brain, an increase in ADC values was found in all areas. ADC changes of eight localizations such as left corpus callosum, right corona radiata, left corona radiata, hippocampus, right insula, left superior cerebellar peduncle, left caudate nucleus and left putamen were statistically significant. UPDRS III scores improved by 57 % (p <0.05), and Beck and Hamilton depression scores by 25 % and 33 %, respectively (p> 0.05).
CONCLUSIONS: This article implicate that bilateral STN-DBS surgery potentially exerts beneficial effects on both motor and neuropsychiatric symptomatology in individuals with PD. We believe that this therapeutic mechanism is hypothesized to involve modulation of diffusion alterations within distinct cerebral tissues.
METHODS: Patients who underwent STN-DBS surgery for PD between 2017 and 2019 were included in this study. The results of diffusion magnetic resonance imaging (MRI), Unified Parkinson Disease Rating Scale (UPDRS) III scores, Beck and Hamilton depression tests were recorded before and at the 3rd month of postoperative stimulation. The data obtained were evaluated with the Wilcoxon signed rank test. Result of the statistical tests were within the 95 % confidence interval and p values were significant below 0.05.
RESULTS: Our study was conducted with a total of 13 patients, 8 men and 5 women. As a result of measurements made in a total of 32 different regions, especially in the motor and neuropsychiatric areas of the brain, an increase in ADC values was found in all areas. ADC changes of eight localizations such as left corpus callosum, right corona radiata, left corona radiata, hippocampus, right insula, left superior cerebellar peduncle, left caudate nucleus and left putamen were statistically significant. UPDRS III scores improved by 57 % (p <0.05), and Beck and Hamilton depression scores by 25 % and 33 %, respectively (p> 0.05).
CONCLUSIONS: This article implicate that bilateral STN-DBS surgery potentially exerts beneficial effects on both motor and neuropsychiatric symptomatology in individuals with PD. We believe that this therapeutic mechanism is hypothesized to involve modulation of diffusion alterations within distinct cerebral tissues.
摘要：
目的：帕金森病（PD）是一种神经退行性疾病，其特征是多巴胺能神经元的数量和功能均减少。这简洁地突出了PD的中枢病理特征及其与多巴胺能神经元变性的关联，这是该疾病的运动和非运动症状的基础。本研究旨在通过双侧丘脑底核（STN）深部脑刺激（DBS）手术后，阐明不同脑区的表观扩散系数（ADC）变化的细微差别。以及研究它们与运动和神经精神光谱的潜在相互作用。
方法：在2017年至2019年期间接受STN-DBS手术治疗的患者被纳入本研究。磁共振弥散成像（MRI）的结果，统一帕金森病评定量表（UPDRS）III评分，在术后刺激的第3个月和第3个月记录贝克和汉密尔顿抑郁测试。获得的数据用Wilcoxon符号秩检验进行评估。统计检验结果在95%置信区间内,p值显著低于0.05。
结果：我们的研究共有13名患者，8男5女由于在总共32个不同地区进行了测量，特别是在大脑的运动和神经精神区域，在所有地区都发现ADC值增加。左体等八种定位的ADC变化，右日冕辐射,左日冕辐射,海马体,右岛，左上小脑花梗,左尾状核和左壳核有统计学意义。UPDRSIII评分提高了57%(p<0.05)，贝克和汉密尔顿的抑郁得分分别为25%和33%，分别为(p>0.05)。
结论：本文暗示双侧STN-DBS手术可能对PD患者的运动和神经精神症状产生有益影响。我们认为，这种治疗机制被认为涉及不同脑组织内扩散改变的调节。
方法：在2017年至2019年期间接受STN-DBS手术治疗的患者被纳入本研究。磁共振弥散成像（MRI）的结果，统一帕金森病评定量表（UPDRS）III评分，在术后刺激的第3个月和第3个月记录贝克和汉密尔顿抑郁测试。获得的数据用Wilcoxon符号秩检验进行评估。统计检验结果在95%置信区间内,p值显著低于0.05。
结果：我们的研究共有13名患者，8男5女由于在总共32个不同地区进行了测量，特别是在大脑的运动和神经精神区域，在所有地区都发现ADC值增加。左体等八种定位的ADC变化，右日冕辐射,左日冕辐射,海马体,右岛，左上小脑花梗,左尾状核和左壳核有统计学意义。UPDRSIII评分提高了57%(p<0.05)，贝克和汉密尔顿的抑郁得分分别为25%和33%，分别为(p>0.05)。
结论：本文暗示双侧STN-DBS手术可能对PD患者的运动和神经精神症状产生有益影响。我们认为，这种治疗机制被认为涉及不同脑组织内扩散改变的调节。
