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Suicide after successful deep brain stimulation for movement disorders
P R Burkhard1, F J G Vingerhoets, A Berney
1Vaud-Geneva Deep Brain Stimulation Program for Movement Disorders, CHUV, Lausanne, Switzerland.
Neurology
|December 15, 2004
Summary
Deep brain stimulation (DBS) showed a high suicide rate (4.3%) in movement disorder patients. History of depression and multiple surgeries were risk factors, leading to a recommendation to exclude high-risk patients from DBS.
Area of Science:
- Neuroscience
- Neurosurgery
- Psychiatry
Background:
- Deep brain stimulation (DBS) is a treatment for movement disorders.
- Patient selection for DBS typically focuses on motor outcomes.
Purpose of the Study:
- To investigate the incidence and risk factors of suicide in patients undergoing DBS for movement disorders.
- To assess the relationship between suicide risk and clinical/surgical factors in DBS patients.
Main Methods:
- Retrospective analysis of a large cohort of patients with movement disorders who underwent DBS.
- Identification of suicide events and analysis of associated clinical and surgical variables.
Main Results:
- A significant suicide rate of 4.3% (6/140 patients) was observed.
- Previous severe depression history and multiple DBS surgeries were identified as key risk factors.
- No correlation was found between suicide and the specific movement disorder, DBS target, or stimulation parameters.
- Paradoxically, all patients who died by suicide had excellent motor outcomes.
Conclusions:
- Patients with a history of severe depression and those requiring multiple DBS surgeries may be at increased risk for suicide post-DBS.
- The potential for excellent motor outcomes does not negate the risk of suicide in susceptible individuals.
- Consideration should be given to excluding patients with high-risk profiles from DBS surgery to mitigate suicide risk.