[Psychiatric symptoms of Parkinson's disease following deep brain stimulation surgery on the subthalamic nucleus]

To review the increasing number of papers that report diverse neuropsychiatric disorders that happen in patients diagnosed of Parkinson's disease submitted to brain deep stimulation of subthalamic nuclei with high frequency current.

It is a fact the need to evaluate carefully all the patients who have to submit to this surgical procedure analyzing previous psychiatric history, and the possible appearance of psychiatric sphere symptoms after surgery. The acute depression and the euphoric moods (than can occur immediately after surgery) and major depression, obsession, widespread anxiety and substance abuse (among those of more delayed appearance) constitute examples of this pathology. The treatment of previous psychiatric disorders is forced in all cases and specially relevant in the major depression when suicide ideas coexist.

Information that allow to predict the risk of developing depressive disorders in the postoperative period does not exist at present time, though it is more predictable that it happens in those patients with previous severe depressive history. In general, euphoric moods, apathy and depression, usually are transient and of multifactorial origin that includes the existence of endogenous predisposition, the change to an independence pattern after surgery, the psychotropic effect of levodopa, and the high frequency current stimulation effect on the non motor structures target and in the adjacent regions. It must be outlined that it is possible the appearance of psychotic symptoms after brain deep stimulation of subthalamic nuclei in patients with ideal results on motor disability.