Journal Article

FZJ-2021-04339

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Predictors of short-term impulsive and compulsive behaviour after subthalamic stimulation in Parkinson disease

Sauerbier, A. (Corresponding author) ; Loehrer, P. ; Jost, S. T. ; Heil, S. ; Petry-Schmelzer, J. N. ; Herberg, J. ; Bachon, P. ; Aloui, S. ; Gronostay, A. ; Klingelhoefer, L. ; Baldermann, J. C. ; Huys, D. ; Nimsky, C. ; Barbe, M. T. ; Fink, G. R.FZJ* ; Martinez-Martin, P. ; Ray Chaudhuri, K. ; Visser-Vandewalle, V. ; Timmermann, L. ; Weintraub, D. ; Dafsari, H. S.

2021
BMJ Publishing Group London

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Please use a persistent id in citations: http://hdl.handle.net/2128/29047  doi:10.1136/jnnp-2021-326131

Abstract: 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.

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Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)

Research Program(s):

1. 5251 - Multilevel Brain Organization and Variability (POF4-525) (POF4-525)

Appears in the scientific report 2021

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