This title appears in the Scientific Report :
2021
Please use the identifier:
http://hdl.handle.net/2128/29047 in citations.
Please use the identifier: http://dx.doi.org/10.1136/jnnp-2021-326131 in citations.
Predictors of short-term impulsive and compulsive behaviour after subthalamic stimulation in Parkinson disease
Predictors of short-term impulsive and compulsive behaviour after subthalamic stimulation in Parkinson disease
Background The effects of subthalamic stimulation (subthalamic nucleus-deep brain stimulation, STN-DBS) on impulsive and compulsive behaviours (ICB) in Parkinson’s disease (PD) are understudied.Objective To investigate clinical predictors of STN-DBS effects on ICB.Methods In this prospective, open-l...
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Personal Name(s): | Sauerbier, Anna (Corresponding author) |
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Loehrer, Philipp / Jost, Stefanie T. / Heil, Shania / Petry-Schmelzer, Jan N. / Herberg, Johanna / Bachon, Pia / Aloui, Salima / Gronostay, Alexandra / Klingelhoefer, Lisa / Baldermann, J. Carlos / Huys, Daniel / Nimsky, Christopher / Barbe, Michael T. / Fink, Gereon R. / Martinez-Martin, Pablo / Ray Chaudhuri, K. / Visser-Vandewalle, Veerle / Timmermann, Lars / Weintraub, Daniel / Dafsari, Haidar S. | |
Contributing Institute: |
Kognitive Neurowissenschaften; INM-3 |
Published in: | Journal of neurology, neurosurgery, and psychiatry, 92 (2021) 12, S. 1313 - 1318 |
Imprint: |
London
BMJ Publishing Group
2021
|
PubMed ID: |
34510000 |
DOI: |
10.1136/jnnp-2021-326131 |
Document Type: |
Journal Article |
Research Program: |
Multilevel Brain Organization and Variability |
Link: |
OpenAccess |
Publikationsportal JuSER |
Please use the identifier: http://dx.doi.org/10.1136/jnnp-2021-326131 in citations.
Background The effects of subthalamic stimulation (subthalamic nucleus-deep brain stimulation, STN-DBS) on impulsive and compulsive behaviours (ICB) in Parkinson’s disease (PD) are understudied.Objective To investigate clinical predictors of STN-DBS effects on ICB.Methods In this prospective, open-label, multicentre study in patients with PD undergoing bilateral STN-DBS, we assessed patients preoperatively and at 6-month follow-up postoperatively. Clinical scales included the Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale (QUIP-RS), PD Questionnaire-8, Non-Motor Symptom Scale (NMSS), Unified PD Rating Scale in addition to levodopa-equivalent daily dose total (LEDD-total) and dopamine agonists (LEDD-DA). Changes at follow-up were analysed with Wilcoxon signed-rank test and corrected for multiple comparisons (Bonferroni method). We explored predictors of QUIP-RS changes using correlations and linear regressions. Finally, we dichotomised patients into ‘QUIP-RS improvement or worsening’ and analysed between-group differences.Results We included 55 patients aged 61.7 years±8.4 with 9.8 years±4.6 PD duration. QUIP-RS cut-offs and psychiatric assessments identified patients with preoperative ICB. In patients with ICB, QUIP-RS improved significantly. However, we observed considerable interindividual variability of clinically relevant QUIP-RS outcomes as 27.3% experienced worsening and 29.1% an improvement. In post hoc analyses, higher baseline QUIP-RS and lower baseline LEDD-DA were associated with greater QUIP-RS improvements. Additionally, the ‘QUIP-RS worsening’ group had more severe baseline impairment in the NMSS attention/memory domain.Conclusions Our results show favourable ICB outcomes in patients with higher preoperative ICB severity and lower preoperative DA doses, and worse outcomes in patients with more severe baseline attention/memory deficits. These findings emphasise the need for comprehensive non-motor and motor symptoms assessments in patients undergoing STN-DBS. |