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“He’s Back so I’m Not Alone”: The Impact of Deep Brain Stimulation on Personality, Self, and Relationships in Parkinson’s Disease

机译:“他回来了,所以我并不孤单”:深脑刺激对帕金森病的人格,自我和关系的影响

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摘要

Deep brain stimulation (DBS) for Parkinson’s disease successfully alleviates motor symptoms, but unanticipated changes in personality, self, and relationships can occur. Little is known about how these nonmotor outcomes affect patients and families. We prospectively examined the experience and meaning of DBS-related changes in personality and self for patients and caregivers. In-depth, semi-structured interviews were conducted with 22 participants (11 patient–caregiver dyads) before and 9 months after DBS and analyzed using thematic analysis. We identified three themes present prior to DBS that reflected a time of anticipation , while three themes present after DBS reflected a process of adjustment . Participants noted both positive and negative personality changes, with some, but not all, attributing them to the stimulation. The risk of stimulation-related personality change should be weighed against the procedure’s motor benefits and considered in the context of disease- and medication-related personality changes. Clinical implications including perioperative education and follow-up management are discussed.
机译:针对帕金森氏症的脑深部刺激(DBS)成功地缓解了运动症状,但人格、自我和人际关系可能会发生意想不到的变化。关于这些非运动性结果如何影响患者和家属,我们知之甚少。我们前瞻性地研究了DBS相关的人格和自我变化对患者和护理者的经验和意义。在DBS前和9个月后,对22名参与者(11名患者-护理者二元)进行了深入的半结构式访谈,并使用主题分析进行了分析。我们确定了DBS之前的三个主题反映了一个预期时间,而DBS之后的三个主题反映了一个调整过程。参与者注意到积极和消极的性格变化,其中一些(但不是全部)归因于刺激。刺激相关人格改变的风险应与手术的运动益处相权衡,并在疾病和药物相关人格改变的背景下考虑。临床意义,包括围手术期教育和后续管理进行了讨论。

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