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| 001 | 902537 | ||
| 005 | 20220103172046.0 | ||
| 024 | 7 | _ | |a 10.1136/jnnp-2021-326131 |2 doi |
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| 100 | 1 | _ | |a Sauerbier, Anna |0 0000-0003-0966-5933 |b 0 |e Corresponding author |
| 245 | _ | _ | |a Predictors of short-term impulsive and compulsive behaviour after subthalamic stimulation in Parkinson disease |
| 260 | _ | _ | |a London |c 2021 |b BMJ Publishing Group |
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| 520 | _ | _ | |a 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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| 700 | 1 | _ | |a Heil, Shania |0 P:(DE-HGF)0 |b 3 |
| 700 | 1 | _ | |a Petry-Schmelzer, Jan N. |0 0000-0003-0749-3840 |b 4 |
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| 773 | _ | _ | |a 10.1136/jnnp-2021-326131 |g Vol. 92, no. 12, p. 1313 - 1318 |0 PERI:(DE-600)1480429-3 |n 12 |p 1313 - 1318 |t Journal of neurology, neurosurgery, and psychiatry |v 92 |y 2021 |x 0022-3050 |
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