Objective To explore the effect of deep brain stimulation of bilateral subthalamic nucleus(STN-DBS)on the mood and cognition in patients with Parkinson's disease(PD).Methods The clinical data of 80 PD patients who underwent bilateral STN-DBS treatment at the Functional Neurosurgery of Affiliated Brain Hospital of Nanjing Medical University from April 2014 to December 2016 were retrospectively analyzed 5 years after surgery.Before surgery,6 months after surgery,and 1,2,3,4,and 5 years later,the patients were assessed based on the Unified Parkinson's Disease Rating Scale Part Ⅲ(UPDRS-Ⅲ),the 39-item PD Quality of Life Questionnaire in the off state(PDQ-39),Hamilton Anxiety Rating Scale(HAMA),Hamilton Depression Rating Scale(HAMD),Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA);the L-dopa equivalent daily dose(LED)was calculated.We compared the changes in scores of patients and the LEDD before and after surgery,and analyze the correlation between the improvement of motor symptoms(UPDRS-Ⅲ score),quality of life(PDQ-39 score)and the improvement rate of MMSE,MoCA,HAMA,and HAMD scores.Results Compared with those before surgery,the patient's UPDRS-Ⅲ score(off period),LEDD,PDQ-39 score,HAMA score,and HAMD score at 6 months,1,2,3,4,and 5 years after surgery were all significantly reduced,the MoCA scores were all higher than those before surgery,and the differences were statistically significant(all P＜0.05).The MMSE scores at 6 months,1,2,3,and 4 years after surgery were higher than those before surgery,and the differences were statistically significant(all P＜0.05),while the MMSE scores at 5 years after surgery were not different from those before surgery(P＞0.05).Spearman rank correlation analysis results showed that there was a positive correlation between the patient's MMSE score improvement rate at 1,3,and 5 years after surgery and the PDQ-39 score improvement rate at the same time points(1 year after surgery:rs=0.26,P=0.026;3 years after surgery:rs=0.23,P=0.043;5 years after surgery:rs=0.35,P=0.002).There was a positive correlation(rs=0.28,P=0.014)between the MoCA score improvement rate 5 years after surgery and the PDQ-39 score improvement rate corresponding to the same time point.There was no significant correlation between the patient's MMSE,MoCA,HAMA,and HAMD score improvement rates at 1,3,and 5 years after surgery and the UPDRS-Ⅲ score improvement rate at the corresponding time points(all P＞0.05).Conclusions Bilateral STN-DBS is long-term effective in improving anxiety,depression and overall cognitive function in PD patients.The improvement in overall cognitive function in PD patients is related to the improvement in quality of life.
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