The effect on deep brain stimulation of subthalamic nucleus and dopaminergic treatment in Parkinson disease

Abstract

Impulsivity is a frequent non-motor symptom in Parkinson disease (PD). It comprises psycho-behavioral alterations that negatively impact quality of life. Dopaminergic treatments underpin many impulsive controls disorders however, side effects, such as increased impulsivity, are described also after neurosurgical procedure of deep brain stimulation (DBS). We investigated the effect of deep brain stimulation on psycho-behavioral alterations and quality of life (QoL) in PD patients, analyzing, also, the role of dopaminergic therapies. Twenty idiopathic PD patients with and 20 idiopathic PD patients without DBS were included in the study. All patient underwent to neuropsychological assessment for a screening of executive functions, impulsivity, anxiety and depressive symptoms and QoL. Differences were found between DBS and no DBS groups and in term of dopaminergic therapies. The comparison between 2 groups showed a greater motor and attentional impulsivity in DBS patients. Moreover, this impulsivity worse QoL and interpersonal relationships. The combination of Levodopa and dopamine agonists exerted a great impact on impulsivity behavior. The emergence of postoperative impulsivity seems to be a neurostimulator phenomenon related to the computational role of the subthalamic nucleus in modulation of behavior.

Impulse Control Disorders in Parkinson’s Disease: From Bench to Bedside

“…Whether non-pharmacological interventions such as deep brain stimulation (DBS) ameliorates or worsens ICRBs in PD patients is still debated. While most human studies indicated that DBS improves PD + ICD, some have reported the development of short-term de novo ICDs following DBS ( Amami et al, 2015 ; Rossi et al, 2017 ; Kim et al, 2018 ; Lo Buono et al, 2020 ; Santin et al, 2020 ). In rodents, decreased risk-taking and loss-chasing was reported following lesioning to the subthalamic nucleus (STN), possibly pinpointing this region as a target for DBS and other treatments for PD + ICD ( Breysse et al, 2020 ).…”

The roles of behavioral inhibition/activation systems and impulsivity in problematic smartphone use: A network analysis

“…Excessive motor impulsivity may lead to difficulty with response inhibition. Hence, failing to resist temptations may result in relapse and acting impulsively may contribute to conflicts with others ( 24 , 105 , 106 ). Another important edge identified in this study was the positive connection between BASR “BAS-reward responsiveness” and PSU5 “withdrawal,” which is similar to the finding that BASR is a predictor of PSU ( 25 ).…”