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Subthalamic deep brain stimulation and impulse control in Parkinson's disease
T D Hälbig1, W Tse, P G Frisina
1Fédération de Neurologie, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France. halbig.psl@gmail.com
European Journal of Neurology
|February 25, 2009
Summary
Deep brain stimulation (DBS) for Parkinson's disease (PD) may increase impulsivity. Patients receiving STN DBS showed higher impulsivity scores and a trend towards more impulse control disorders compared to those on medication.
Area of Science:
- Neuroscience
- Neurology
- Psychiatry
Background:
- Subthalamic nucleus deep brain stimulation (STN DBS) is a treatment for Parkinson's disease (PD).
- Previous studies suggest STN DBS may induce impulsivity in PD patients.
Purpose of the Study:
- To compare impulse control measures in PD patients with STN DBS versus those on medical therapy.
- To assess impulsivity, impulse control disorders (ICDs), and obsessive-compulsive symptoms.
Main Methods:
- Cross-sectional study of 53 PD patients.
- Assessed impulsivity using the Barratt Impulsiveness Scale.
- Evaluated ICDs with the Minnesota Impulsive Disorders Interview and obsessive-compulsive symptoms with the Maudsley Obsessional-Compulsive Inventory.
Main Results:
- STN DBS patients had significantly higher impulsivity scores than medically treated patients.
- Impulse control disorders (ICDs) were diagnosed in 19% of DBS patients versus 8% of medically treated patients.
- No significant difference in compulsivity scores; no association between dopamine agonists and impulsivity in DBS patients.
Conclusions:
- PD patients undergoing STN DBS may experience increased impulsivity and ICDs.
- Pre-DBS screening and ongoing monitoring for impulsivity and ICDs are recommended.
- Further prospective trials are needed to confirm these findings and understand the mechanisms of STN DBS-induced impulsivity.
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