Parkinson's disease(PD)is a chronic and progressive degenerative disorder of brain commonly seen among the elderly.As conventionally medical therapy is of limited relief and potential side effects,complementary and alternative medicine(CAM)has attracted growing public and professional attention.Therapies such as acupuncture,musical/rhythmic therapy and deep brain stimulation have been gradually proved positively in clinic.In this review,we retrospected the scientific or evidence-based-medicine advances of application and research for modern treatment of PD by CAM,especially traditional Chinese medicine in categories.
HAN LuXIE Yuan-hongWU RongCHEN ChenZHANG YanWANG Xiao-ping
Deep brain stimulation (DBS) is an effective technique for treating Parkinson’s disease (PD) in the middle and advanced stages. The subthalamic nucleus (STN) is the most common target for clinical treatment using DBS. While STN-DBS can significantly improve motor symptoms in PD patients, adverse cognitive effects have also been reported. The specific effects of STN-DBS on cognitive function and the related mechanisms remain unclear. Thus, it is imperative to identify the influence of STN-DBS on cognition and investigate the potential mechanisms to provide a clearer view of the various cognitive sequelae in PD patients. For this review, a literature search was performed using the following inclusion criteria: (1) at least 10 patients followed for a mean of at least 6 months after surgery since the year 2006; (2) pre- and postoperative cognitive data using at least one standardized neuropsychological scale; and (3) adequate reporting of study results using means and standard deviations. Of ~170 clinical studies identified, 25 cohort studies (including 15 self-controlled studies, nine intergroup controlled studies, and one multi-center, randomized control experiment) and one metaanalysis were eligible for inclusion. The results suggest that the precise mechanism of the changes in cognitive function after STN-DBS remains obscure, but STN-DBS certainly has effects on cognition. In particular, a progressive decrease in verbal fluency after STN-DBS is consistently reported and although executive function is unchanged in the intermediate stage postoperatively, it tends to decline in the early and later stages. However, these changes do not affect the improvements in quality of life. STN-DBS seems to be safe with respect to cognitive effects in carefully-selected patients during a follow-up period from 6 months to 9 years.
2012年5月4至7日,由上海交通大学附属第一人民医院、华东地区六省一市神经病学协作委员会、中华医学会神经科分会神经心理学组、上海医学会脑电图和神经生理学协会等联合举办的第二届国际神经退行性疾病学术研讨会(2ed International Conference of Cognitive Movement Disorders & Degeneration)在上海召开.这是继2010年首届大会时隔2年之后的又一次盛会,同时也是对庆祝上海交通大学医学院(原上海第二医科大学)建院60周年的贺礼.
