Abstract：
OBJECTIVE: The effects of stimulation frequency on verbal fluency (VF) following subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson\'s disease (PD) are not well understood. The present study examines the impact stimulation frequency has on VF following bilateral STN-DBS in PD.
METHODS: Prospective study of 38 consecutive patients with PD with low frequency STN-DBS (LFS) (n = 10) and high frequency STN-DBS (HFS) (n = 14), and a non-operated PD control group consisting of patients with fluctuating response to dopaminergic medication (n = 14) homogeneous in age, education, disease duration, and global cognitive function. Patients were evaluated on VF tasks (letter, semantic, action verbs, alternating). A one-way analysis of variance (ANOVA) was conducted to assess distinctions between groups. Pre- and post-surgical comparisons of fluencies were performed for operated groups. A mixed ANOVA was applied to the data to evaluate the interaction between treatment (HFS vs. LFS) and time (pre- vs. post-surgery). Strategy use (clustering and switching) was evaluated.
RESULTS: Semantic and letter fluency performance revealed significant differences between HFS and LFS groups. Pre- and post-surgical comparisons revealed HFS negatively affected letter, semantic, and action fluencies, but LFS had no effect on VF. No interaction effect or main effect of treatment was found. Main effect of time was significant for semantic and action fluencies indicating a decrease in postoperative fluency performance. Patients with LFS produced larger average cluster sizes than patients with HFS.
CONCLUSIONS: LFS may be less detrimental to VF, but these findings suggest that VF decline following STN-DBS is not caused by stimulation frequency alone.
METHODS: Prospective study of 38 consecutive patients with PD with low frequency STN-DBS (LFS) (n = 10) and high frequency STN-DBS (HFS) (n = 14), and a non-operated PD control group consisting of patients with fluctuating response to dopaminergic medication (n = 14) homogeneous in age, education, disease duration, and global cognitive function. Patients were evaluated on VF tasks (letter, semantic, action verbs, alternating). A one-way analysis of variance (ANOVA) was conducted to assess distinctions between groups. Pre- and post-surgical comparisons of fluencies were performed for operated groups. A mixed ANOVA was applied to the data to evaluate the interaction between treatment (HFS vs. LFS) and time (pre- vs. post-surgery). Strategy use (clustering and switching) was evaluated.
RESULTS: Semantic and letter fluency performance revealed significant differences between HFS and LFS groups. Pre- and post-surgical comparisons revealed HFS negatively affected letter, semantic, and action fluencies, but LFS had no effect on VF. No interaction effect or main effect of treatment was found. Main effect of time was significant for semantic and action fluencies indicating a decrease in postoperative fluency performance. Patients with LFS produced larger average cluster sizes than patients with HFS.
CONCLUSIONS: LFS may be less detrimental to VF, but these findings suggest that VF decline following STN-DBS is not caused by stimulation frequency alone.
摘要：
目的：在帕金森病（PD）的丘脑底核深部脑刺激（STN-DBS）后，刺激频率对言语流畅性（VF）的影响尚不清楚。本研究检查了PD中双侧STN-DBS后刺激频率对VF的影响。
方法：对38例连续PD患者进行低频STN-DBS（LFS）（n=10）和高频STN-DBS（HFS）（n=14）的前瞻性研究，和一个非手术的PD对照组，包括对多巴胺能药物反应波动的患者（n=14），年龄均匀，教育,疾病持续时间,和全球认知功能。对患者进行了VF任务评估(字母，语义，动作动词,交替)。进行单向方差分析(ANOVA)以评估组间的区别。对手术组进行了手术前和手术后的流畅性比较。将混合方差分析应用于数据，以评估治疗之间的相互作用(HFS与LFS）和时间（前与手术后）。评估了策略使用(聚类和切换)。
结果：语义和字母流畅性表现揭示了HFS和LFS组之间的显着差异。术前和术后比较显示HFS受到负面影响，语义，和行动流畅，但LFS对VF没有影响。未发现治疗的交互效应或主要效应。时间对语义和动作流畅性的主要影响显着，表明术后流畅性表现下降。LFS患者比HFS患者产生更大的平均簇大小。
结论：LFS对VF的危害可能较小，但是这些发现表明，STN-DBS后VF下降并非仅由刺激频率引起。
方法：对38例连续PD患者进行低频STN-DBS（LFS）（n=10）和高频STN-DBS（HFS）（n=14）的前瞻性研究，和一个非手术的PD对照组，包括对多巴胺能药物反应波动的患者（n=14），年龄均匀，教育,疾病持续时间,和全球认知功能。对患者进行了VF任务评估(字母，语义，动作动词,交替)。进行单向方差分析(ANOVA)以评估组间的区别。对手术组进行了手术前和手术后的流畅性比较。将混合方差分析应用于数据，以评估治疗之间的相互作用(HFS与LFS）和时间（前与手术后）。评估了策略使用(聚类和切换)。
结果：语义和字母流畅性表现揭示了HFS和LFS组之间的显着差异。术前和术后比较显示HFS受到负面影响，语义，和行动流畅，但LFS对VF没有影响。未发现治疗的交互效应或主要效应。时间对语义和动作流畅性的主要影响显着，表明术后流畅性表现下降。LFS患者比HFS患者产生更大的平均簇大小。
结论：LFS对VF的危害可能较小，但是这些发现表明，STN-DBS后VF下降并非仅由刺激频率引起。
