Behavioural disorders, Parkinson's disease and subthalamic stimulation

Area of Science:

• Neurology
• Neurosurgery
• Psychiatry

Background:

• Subthalamic nucleus (STN) stimulation is a neurosurgical intervention for Parkinson's disease.
• The impact of STN stimulation on behavioral and psychiatric outcomes requires further investigation.

Purpose of the Study:

• To analyze behavioral disorders in 24 Parkinson's disease patients after bilateral STN stimulation.
• To assess the relationship between motor improvement and psychological well-being post-STN stimulation.

Main Methods:

• Retrospective evaluation of 24 Parkinson's disease patients treated with bilateral STN stimulation.
• Assessment of adjustment disorders using the Social Adjustment Scale (SAS).
• Psychiatric evaluation using psychiatric interviews and the Mini International Neuropsychiatric Inventory (MINI).
• Evaluation of personality changes using the Iowa Scale of Personality Changes.

Main Results:

• Significant improvement in Parkinsonian motor disability (69.5%) and reduced levodopa equivalent daily dosage (60.5%).
• Social adjustment was impaired in 15 patients; 9 showed good or excellent adjustment.
• Observed psychiatric disorders included decompensation of pre-existing conditions like depression and anxiety, and new-onset behavioral issues.
• Emotional hyperreactivity was reported in 15 patients; personality traits showed mixed results (improvement, no change, or aggravation).

Conclusions:

• Motor improvement from STN stimulation does not guarantee enhanced psychic function or quality of life.
• Potential for new or worsened personality and psychiatric disorders post-STN stimulation necessitates careful pre-operative screening.
• Pre- and post-operative psychological and psychiatric evaluations are crucial for optimizing outcomes in Parkinson's disease patients undergoing neurosurgery.