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000902537 1001_ $$00000-0003-0966-5933$$aSauerbier, Anna$$b0$$eCorresponding author
000902537 245__ $$aPredictors of short-term impulsive and compulsive behaviour after subthalamic stimulation in Parkinson disease
000902537 260__ $$aLondon$$bBMJ Publishing Group$$c2021
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000902537 520__ $$aBackground 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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000902537 7001_ $$0P:(DE-HGF)0$$aLoehrer, Philipp$$b1
000902537 7001_ $$00000-0003-0477-2289$$aJost, Stefanie T.$$b2
000902537 7001_ $$0P:(DE-HGF)0$$aHeil, Shania$$b3
000902537 7001_ $$00000-0003-0749-3840$$aPetry-Schmelzer, Jan N.$$b4
000902537 7001_ $$0P:(DE-HGF)0$$aHerberg, Johanna$$b5
000902537 7001_ $$0P:(DE-HGF)0$$aBachon, Pia$$b6
000902537 7001_ $$0P:(DE-HGF)0$$aAloui, Salima$$b7
000902537 7001_ $$0P:(DE-HGF)0$$aGronostay, Alexandra$$b8
000902537 7001_ $$0P:(DE-HGF)0$$aKlingelhoefer, Lisa$$b9
000902537 7001_ $$00000-0001-5851-9268$$aBaldermann, J. Carlos$$b10
000902537 7001_ $$00000-0002-9124-4128$$aHuys, Daniel$$b11
000902537 7001_ $$0P:(DE-HGF)0$$aNimsky, Christopher$$b12
000902537 7001_ $$0P:(DE-Juel1)131613$$aBarbe, Michael T.$$b13
000902537 7001_ $$0P:(DE-Juel1)131720$$aFink, Gereon R.$$b14
000902537 7001_ $$0P:(DE-HGF)0$$aMartinez-Martin, Pablo$$b15
000902537 7001_ $$0P:(DE-HGF)0$$aRay Chaudhuri, K.$$b16
000902537 7001_ $$0P:(DE-HGF)0$$aVisser-Vandewalle, Veerle$$b17
000902537 7001_ $$0P:(DE-HGF)0$$aTimmermann, Lars$$b18
000902537 7001_ $$0P:(DE-HGF)0$$aWeintraub, Daniel$$b19
000902537 7001_ $$00000-0001-8849-4233$$aDafsari, Haidar S.$$b20
000902537 773__ $$0PERI:(DE-600)1480429-3$$a10.1136/jnnp-2021-326131$$gVol. 92, no. 12, p. 1313 - 1318$$n12$$p1313 - 1318$$tJournal of neurology, neurosurgery, and psychiatry$$v92$$x0022-3050$$y2021
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