Long-term effect of bilateral STN-DBS on non-motor symptoms in Parkinson's disease: A four-year observational, prospective study

Georgiev, Dejan; Mencinger, Maruša; Rajnar, Robert; Mušič, Polona; Benedičič, Mitja; Flisar, Dušan; Bošnjak, Roman; Mehrkens, Jan H.; Pirtošek, Zvezdan; Boetzel, Kai; Trošt, Maja

doi:10.1016/j.parkreldis.2021.06.017

Cited by 24 publications

(16 citation statements)

References 24 publications

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“…STN-DBS was found to have a positive effect on subjective sleep/fatigue symptoms, while there were no significant changes in mood/apathy at 36 months after STN-DBS [ 8 ]. In a recent study, we also observed an overall improvement in non-motor symptoms, as well as improvement in anxiety, depression, sleep, and health-related quality of life up to 48 months after STN-DBS [ 9 ]. On the other hand, in a prospective study, Funkiewiez et al found a slight increase in symptoms of apathy, a slight increase in depression, and rare transient behavioral changes [ 14 ].…”

Section: Introductionmentioning

confidence: 79%

Personality Changes After Subthalamic Nucleus Stimulation in Parkinson’s Disease

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Pažek

Kavčič

et al. 2022

JPD

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Background: While deep brain stimulation of the subthalamic nucleus (STN-DBS) significantly improves motor deficits in patients with Parkinson’s disease (PD), it is still unclear whether it affects personality functioning. Objective: The objective of the present study was to examine personality changes in patients with PD after STN-DBS from the perspectives of both the patients and caregivers. Moreover, by assessing the premorbid personalities of the patients, we tried to determine individual vulnerability to STN-DBS-induced personality changes. Methods: In total, 27 patients and their caregivers participated in our retrospective observational study. They were asked to assess the patients’ personality changes with the Iowa Scale of Personality Changes (ISPC) and the patients’ premorbid personalities with the Big Five Inventory (BFI). Results: Caregivers reported significant personality changes in the ISPC domains of Executive Disturbance (p = 0.01) and Disturbed Social Behavior (p = 0.02). Most of the ISPC domains were positively correlated with Conscientiousness, while Executive Disturbance was negatively correlated with Neuroticism of the BFI scale. Conclusion: Our results show that executive and social functioning are the two most vulnerable domains in patients with PD after STN-DBS, especially in those patients who score higher for neuroticism and lower for conscientiousness on the BFI scale. The results of our study may provide movement disorder specialists with better counseling options and better selection of DBS candidates. Caregivers’ perspective might contribute significantly in understanding postoperative personality changes.

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Section: Introductionmentioning

confidence: 79%

Personality Changes After Subthalamic Nucleus Stimulation in Parkinson’s Disease

Brezovar

Pažek

Kavčič

et al. 2022

JPD

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“…DBS also exerts effects on non-motor systems. For example, sleep was improved and anxiety alleviated by DBS during a 4-year follow-up in PD [ 13 ]. So far, no evidence on neuronal plasticity induced by DBS in humans is available.…”

Section: Introductionmentioning

confidence: 99%

Deep brain stimulation of subthalamic nucleus modulates cortical auditory processing in advanced Parkinson’s Disease

et al. 2022

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Deep brain stimulation (DBS) has proven its clinical efficacy in Parkinson’s disease (PD), but its exact mechanisms and cortical effects continue to be unclear. Subthalamic (STN) DBS acutely modifies auditory evoked responses, but its long-term effect on auditory cortical processing remains ambiguous. We studied with magnetoencephalography the effect of long-term STN DBS on auditory processing in patients with advanced PD. DBS resulted in significantly increased contra-ipsilateral auditory response latency difference at ~100 ms after stimulus onset compared with preoperative state. The effect is likely due to normalization of neuronal asynchrony in the auditory pathways. The present results indicate that STN DBS in advanced PD patients has long-lasting effects on cortical areas outside those confined to motor processing. Whole-head magnetoencephalography provides a feasible tool to study motor and non-motor neural networks in PD, and to track possible changes related to cortical reorganization or plasticity induced by DBS.

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“…Parkinson’s disease (PD) is a common neurodegenerative disease. Its main clinical symptoms include static tremors, muscle rigidity, and bradykinesia [ 1 ]. Deep brain stimulation (DBS) of the subthalamic nuclei is a standard treatment option for advanced PD patients.…”

Section: Introductionmentioning

confidence: 99%

“…Deep brain stimulation (DBS) of the subthalamic nuclei is a standard treatment option for advanced PD patients. Bilateral STN-DBS improves motor and a variety of non-motor symptoms [ 1 , 2 ], as well as health-related quality of life [ 3 , 4 ]. DBS can also reduce the levodopa medication dose and ameliorate the side effects associated with levodopa therapy [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…The use of propofol-based anesthesia has been associated with reduced postoperative nausea and vomiting and atmospheric pollution as well as a reduced chance of triggering malignant hyperthermia [ 7 ]. Sevoflurane-based inhalational anesthesia is known for bronchodilation, pre- and post-ischemic conditioning, lower costs, and ease of delivery and use [ 1 ]. Previous evidence suggests that the choice of anesthetics may also influence postoperative cognitive status.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Propofol versus Sevoflurane on Postoperative Delirium in Parkinson’s Disease Patients Undergoing Deep Brain Stimulation Surgery: An Observational Study

Zhou

et al. 2022

Brain Sciences

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Background: The selection of the maintenance of general anesthesia may affect the development of postoperative delirium (POD), notably for Parkinson’s disease (PD) patients, due to their lower cognitive reserve. The present study was designed to compare the potential impact of propofol vs. sevoflurane based general anesthesia maintenance methods on the development of POD in PD patients following deep brain stimulation (DBS) surgery. Methods: A total of 125 PD patients who were scheduled to undergo DBS surgery were randomly divided into the propofol (n = 63) and the sevoflurane groups (n = 62). The patients in the two groups randomly received propofol- or sevoflurane-based general anesthesia. The Confusion Assessment Method (CAM) was employed by an investigator who was blinded to the anesthesia regimen and was administered twice per day from postoperative day 1 until discharge. Results: The incidence of POD was 22.22% (14/63) with propofol anesthesia and 20.97% (13/62) with sevoflurane anesthesia (p = 0.865). In addition, no difference was noted in the duration and severity of delirium between the propofol and sevoflurane groups. Conclusions: In the present study, propofol- and sevoflurane-based general anesthesia exhibited comparable results with regard to the POD incidence in PD patients undergoing deep brain stimulation surgery.

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Long-term effect of bilateral STN-DBS on non-motor symptoms in Parkinson's disease: A four-year observational, prospective study

Cited by 24 publications

References 24 publications

Personality Changes After Subthalamic Nucleus Stimulation in Parkinson’s Disease

Personality Changes After Subthalamic Nucleus Stimulation in Parkinson’s Disease

Deep brain stimulation of subthalamic nucleus modulates cortical auditory processing in advanced Parkinson’s Disease

The Effect of Propofol versus Sevoflurane on Postoperative Delirium in Parkinson’s Disease Patients Undergoing Deep Brain Stimulation Surgery: An Observational Study

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