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Impulse control behaviours in patients with Parkinson's disease after subthalamic deep brain stimulation: de novo cases and 3-year follow-up
  1. P Amami1,
  2. I Dekker2,
  3. S Piacentini1,
  4. F Ferré1,
  5. L M Romito1,
  6. A Franzini3,
  7. E M J Foncke2,
  8. A Albanese1,4
  1. 1Neurologia I, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy
  2. 2Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
  3. 3Neurochirurgia III, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy
  4. 4Istituto di Neurologia, Università Cattolica del Sacro Cuore, Milano, Italy
  1. Correspondence to Professor Alberto Albanese, Istituto Neurologico Carlo Besta, Via Celoria, 11, Milano 20133, Italy; alberto.albanese{at}unicatt.it

Abstract

Objective To document the occurrence of impulse control behaviours (ICBs) in patients with Parkinson's disease after 3 years of continuous deep brain stimulation (DBS) of the subthalamic nucleus (STN).

Methods Detailed neurological and ICB assessments were performed before STN DBS and up to 3 years after implant.

Results 13 out of 56 patients (23.2%) had ICBs at baseline; they took higher doses of dopamine agonists (DAA). Three years after implant 11 had fully remitted with a 60.8% reduction of DAA medication; the remaining two, who had a similar medication reduction, had only compulsive eating, having recovered from hypersexuality. Six of the 43 patients without ICBs at baseline (14%) developed transient de novo ICBs after implant; none of them had ICBs at the 3-year observation.

Conclusions ICBs were abolished in patients 3 years after STN DBS and DAA dosages were lowered. New ICBs may occur after implant and are transient in most cases. Compulsive eating may be specifically related to STN stimulation.

  • Parkinson's Disease
  • Surgery
  • Behavioural Disorder

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