TY  - JOUR
AU  - Sauerbier, Anna
AU  - Loehrer, Philipp
AU  - Jost, Stefanie T.
AU  - Heil, Shania
AU  - Petry-Schmelzer, Jan N.
AU  - Herberg, Johanna
AU  - Bachon, Pia
AU  - Aloui, Salima
AU  - Gronostay, Alexandra
AU  - Klingelhoefer, Lisa
AU  - Baldermann, J. Carlos
AU  - Huys, Daniel
AU  - Nimsky, Christopher
AU  - Barbe, Michael T.
AU  - Fink, Gereon R.
AU  - Martinez-Martin, Pablo
AU  - Ray Chaudhuri, K.
AU  - Visser-Vandewalle, Veerle
AU  - Timmermann, Lars
AU  - Weintraub, Daniel
AU  - Dafsari, Haidar S.
TI  - Predictors of short-term impulsive and compulsive behaviour after subthalamic stimulation in Parkinson disease
JO  - Journal of neurology, neurosurgery, and psychiatry
VL  - 92
IS  - 12
SN  - 0022-3050
CY  - London
PB  - BMJ Publishing Group
M1  - FZJ-2021-04339
SP  - 1313 - 1318
PY  - 2021
AB  - 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.
LB  - PUB:(DE-HGF)16
C6  - pmid:34510000
UR  - <Go to ISI:>//WOS:000722666700001
DO  - DOI:10.1136/jnnp-2021-326131
UR  - https://juser.fz-juelich.de/record/902537
ER  -