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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2014.tde-13012015-145702
Document
Author
Full name
Alessandra Shenandoa Heluani
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2014
Supervisor
Committee
Cukiert, Arthur (President)
Lara Júnior, Nilton Alves
Machado, Alexandre Aluizio Costa
Title in Portuguese
Cognição, humor e atividades funcionais em pacientes com doença de Parkinson submetidos à estimulação cerebral profunda bilateral em núcleo subtalâmico
Keywords in Portuguese
Cognição
Doença de Parkinson
Estimulação cerebral profunda
Neuropsicologia
Núcleo subtalâmico
Abstract in Portuguese
Introdução: A estimulação cerebral profunda (DBS) tem sido utilizada para controle das alterações motoras nos pacientes com Doença de Parkinson (DP). O núcleo subtalâmico (NST) é o alvo preferencialmente escolhido na cirurgia. Entretanto, a técnica tem sido associada com declínio cognitivo, principalmente na fluência verbal, alterações de humor e de comportamento. Objetivo: Verificar a ocorrência de alterações na cognição, humor e atividades funcionais por meio de avaliação neuropsicológica. Métodos: Vinte e um pacientes submetidos à cirurgia no período de Maio de 2008 a Março de 2013 foram examinados por meio da avaliação neuropsicológica incluindo testes de memória, funções executivas, funções atencionais, linguagem, praxia, escala hospitalar de depressão e ansiedade (HADS) e atividades funcionais (Pfeffer), nas fases pré e pós-operatória. Os dados foram analisados utilizando SPSS versão 17.0 e os resultados foram comparados através do teste pareado t-Student ou chi-quadrado. Foi adotado um nível de significância igual ou menor que 5% (p < 0,05) para todas as análises. Resultados: Não foram encontradas diferenças significativas nas funções cognitivas, no humor e nas atividades funcionais avaliadas. Resultado marginal foi observado na memória episódica imediata verbal (p=0,051). Conclusão: DBS-NST parece não ter impacto negativo nas funções cognitivas e humor. Apesar da amostra ser relativamente pequena, a técnica parece ser segura do ponto de visto cognitivo em pacientes adequadamente selecionados
Title in English
Cognition, mood and activities of daily living assessment in patients with Parkinson's disease submitted to bilateral deep brain stimulation in the subthalamic nucleus
Keywords in English
Cognition
Deep brain stimulation
Neuropsychologia
Parkinson's disease
Subthalamic nucleus
Abstract in English
Introdution: Deep brain stimulation (DBS) has been used for control of motor disorders in patients with Parkinson's disease (PD). The subthalamic nucleus (STN) is the main target used in surgery. However, the technique has been associated with cognitive decline, mainly in verbal fluency, mood and behavior. Objective: To investigate the occurrence of changes in cognition, mood, and activities of daily living through neuropsychological assessment. Methods: Twenty one patients operated between May, 2008 and March, 2013 were submitted to pre- and post-operative neuropsychological testing including memory, executive functions, attentional functions, language and praxis assessment, and to hospital anxiety and depression scale (HADS) and activities of daily living (Pfeffer) scale rating as well. Data were analyzed using SPSS version 17.0 and the results were compared using the paired Student t-test or chi-square. A significance level equal or lower than 5% (p < 0.05) was adopted. Results: No significant differences were found in cognitive functions, mood and activities of daily living. Marginal results were observed in immediate verbal episodic memory (p=0.051). Conclusion: DBS - STN did not show a negative impact on cognitive function, mood and daily activities. Despite the relatively small sample, the technique appears to be safe from the cognitive point of view in appropriately selected patients
 
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Publishing Date
2015-01-13
 
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