Personality Related to Quality-of-Life Improvement After Deep Brain Stimulation in Parkinson’s Disease (PSYCHO-STIM II)

Abstract

Background: Deep brain stimulation of the sub-thalamic nucleus (DBS-STN) reduces symptoms in Parkinson’s disease (PD) patients with motor fluctuations. However, some patients may not feel ameliorated afterwards, despite an objective motor improvement. It is thus important to find new predictors of patients’ quality of life (QoL) amelioration after DBS-STN. We hypothesized that personality dimensions might affect QoL after DBS-STN. Objective: To evaluate associations between personality dimensions and QoL improvement one year after DBS-STN. Methods: DBS-STN-PD patients (n = 303) having answered the “Temperament and Character Inventory” (TCI) before surgery and the PDQ-39 before and one year after surgery were included, from the cohort study PREDI-STIM. Linear regression models were used to evaluate associations between TCI dimensions and change in PDQ-39 scores after DBS-STN. Results: Novelty Seeking and Cooperativeness scores before surgery were positively associated with PDQ-39 scores improvement after DBS-STN (FDR-adjusted p < 0.01). Moreover, paradoxically unimproved patients with deterioration of their PDQ-39 scores after DBS-STN despite improvement of their MDS-UPDRS-IV scores had lower Cooperativeness scores, while paradoxically improved patients with amelioration of their PDQ-39 scores despite deterioration of their MDS-UPDRS-IV scores had higher Reward Dependence scores. Conclusion: Some presurgical personality dimensions were significantly associated with QoL amelioration and discrepancy between motor state and QoL changes after DBS-STN in PD. Educational programs before DBS-STN should take in account patient personality dimensions to better deal with their expectations.

Personality and quality-of-life improvement after apomorphine infusion in Parkinson’s disease

“… 12 Hence, personality was shown to be associated with health-related QoL in different studies, 13 as previously reported in Parkinson’s disease. 14 In this respect, personality could be an interesting factor for predicting QoL improvement after CSAI, as it was associated with QoL improvement after DBS-STN 15 using the Temperament and Character Inventory (TCI) (validated in a large cohort of PwPD 16 ), which provides a quantitative measure of seven personality dimensions. 17 …”

“…In the absence of randomized controlled trials comparing the improvement induced by second-line treatments (DBS-STN versus CSAI), 1 patients’ choice and clinical judgement remain the main factors in treatment choice. 1 Since our previous study showed that PwPD with higher novelty seeking (NS) and cooperativeness scores had the best improvement of QoL after DBS-STN, 15 personality could help to select the best treatment.…”

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

“…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 ].…”

Association between Baseline Cognitive Score and Postoperative Delirium in Parkinson’s Disease Patients following Deep Brain Stimulation Surgery

“…Deep brain stimulation of the subthalamic nuclei (STN-DBS) is a standard treatment option for advanced PD patients. Bilateral STN-DBS not only improves motor symptoms but also a variety of nonmotor symptoms [2][3][4], as well as health-related quality of life [2,5]. DBS could also reduce the levodopa medication dose and ameliorate the side e ects associated with levodopa therapy [4].…”