RT Journal Article
SR Electronic
T1 Predictors of short-term impulsive and compulsive behaviour after subthalamic stimulation in Parkinson disease
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 1313
OP 1318
DO 10.1136/jnnp-2021-326131
VO 92
IS 12
A1 Sauerbier, Anna
A1 Loehrer, Philipp
A1 Jost, Stefanie T.
A1 Heil, Shania
A1 Petry-Schmelzer, Jan N.
A1 Herberg, Johanna
A1 Bachon, Pia
A1 Aloui, Salima
A1 Gronostay, Alexandra
A1 Klingelhoefer, Lisa
A1 Baldermann, J. Carlos
A1 Huys, Daniel
A1 Nimsky, Christopher
A1 Barbe, Michael T.
A1 Fink, Gereon R.
A1 Martinez-Martin, Pablo
A1 Ray Chaudhuri, K.
A1 Visser-Vandewalle, Veerle
A1 Timmermann, Lars
A1 Weintraub, Daniel
A1 Dafsari, Haidar S.
A1 
YR 2021
UL http://jnnp.bmj.com/content/92/12/1313.abstract
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.