PT  - JOURNAL ARTICLE
AU  - Anna Sauerbier
AU  - Philipp Loehrer
AU  - Stefanie T. Jost
AU  - Shania Heil
AU  - Jan N. Petry-Schmelzer
AU  - Johanna Herberg
AU  - Pia Bachon
AU  - Salima Aloui
AU  - Alexandra Gronostay
AU  - Lisa Klingelhoefer
AU  - J. Carlos Baldermann
AU  - Daniel Huys
AU  - Christopher Nimsky
AU  - Michael T. Barbe
AU  - Gereon R. Fink
AU  - Pablo Martinez-Martin
AU  - K. Ray Chaudhuri
AU  - Veerle Visser-Vandewalle
AU  - Lars Timmermann
AU  - Daniel Weintraub
AU  - Haidar S. Dafsari
ED  - ,
TI  - Predictors of short-term impulsive and compulsive behaviour after subthalamic stimulation in Parkinson disease
AID  - 10.1136/jnnp-2021-326131
DP  - 2021 Dec 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 1313--1318
VI  - 92
IP  - 12
4099  - http://jnnp.bmj.com/content/92/12/1313.short
4100  - http://jnnp.bmj.com/content/92/12/1313.full
SO  - J Neurol Neurosurg Psychiatry2021 Dec 01; 92
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.Trial registration number DRKS00006735.Data are available on reasonable request.