Sauerbier, Anna, Loehrer, Philipp, Jost, Stefanie T., Heil, Shania, Petry-Schmelzer, Jan N., Herberg, Johanna, Bachon, Pia, Aloui, Salima, Gronostay, Alexandra, Klingelhoefer, Lisa, Baldermann, J. Carlos, Huys, Daniel ORCID: 0000-0002-9124-4128, Nimsky, Christopher ORCID: 0000-0002-8216-9410, Barbe, Michael T. ORCID: 0000-0003-1149-8054, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Martinez-Martin, Pablo, Ray Chaudhuri, K., Visser-Vandewalle, Veerle, Timmermann, Lars, Weintraub, Daniel and Dafsari, Haidar S. (2021). Predictors of short-term impulsive and compulsive behaviour after subthalamic stimulation in Parkinson disease. J. Neurol. Neurosurg. Psychiatry, 92 (12). S. 1313 - 1319. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-330X

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Abstract

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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Sauerbier, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Loehrer, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jost, Stefanie T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heil, ShaniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petry-Schmelzer, Jan N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herberg, JohannaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bachon, PiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aloui, SalimaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gronostay, AlexandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klingelhoefer, LisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baldermann, J. CarlosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huys, DanielUNSPECIFIEDorcid.org/0000-0002-9124-4128UNSPECIFIED
Nimsky, ChristopherUNSPECIFIEDorcid.org/0000-0002-8216-9410UNSPECIFIED
Barbe, Michael T.UNSPECIFIEDorcid.org/0000-0003-1149-8054UNSPECIFIED
Fink, Gereon R.UNSPECIFIEDorcid.org/0000-0002-8230-1856UNSPECIFIED
Martinez-Martin, PabloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ray Chaudhuri, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Visser-Vandewalle, VeerleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Timmermann, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weintraub, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dafsari, Haidar S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-602038
DOI: 10.1136/jnnp-2021-326131
Journal or Publication Title: J. Neurol. Neurosurg. Psychiatry
Volume: 92
Number: 12
Page Range: S. 1313 - 1319
Date: 2021
Publisher: BMJ PUBLISHING GROUP
Place of Publication: LONDON
ISSN: 1468-330X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
DEEP-BRAIN-STIMULATION; QUALITY-OF-LIFE; NONMOTOR SYMPTOMS; RATING-SCALE; DISORDERS; DOPAMINE; NUCLEUS; QUESTIONNAIRE; VALIDATION; NEUROSTIMULATIONMultiple languages
Clinical Neurology; Psychiatry; SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60203

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