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Deep brain stimulation and behavioural changes: is comedication the most important factor?

Dorothée Lulé1, Johanna Heimrath, Elmar H Pinkhardt

  • 1Department of Neurology, University of Ulm, Germany. dorothee.lule @ uni-ulm.de

Neuro-Degenerative Diseases
|July 23, 2011
PubMed
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Parkinson's disease patients on dopaminergic medication (DA) show more impulsive behavior. Deep brain stimulation (DBS) may reduce this impulsivity, especially with lower DA doses.

Area of Science:

  • Neuroscience
  • Neurology
  • Behavioral Science

Background:

  • Dopaminergic medication (DA) is linked to impulsive behavior and decision-making issues in Parkinson's disease (PD).
  • Deep brain stimulation (DBS) is an effective PD treatment but may cause behavioral complications.

Purpose of the Study:

  • To investigate impulsive behavior in Parkinson's disease patients under different treatment conditions.
  • To compare impulsivity in patients with and without DBS, and under varying dopaminergic medication (DA) levels.

Main Methods:

  • Assessed 15 Parkinson's disease patients with DBS (PD-DBS) with stimulation on and off.
  • Compared PD-DBS patients to 15 Parkinson's disease patients on DA medication (PD-DA), matched for age and disease duration.
  • Measured impulsive behavior via a gambling task, alongside neuropsychological assessments.

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Main Results:

  • PD-DA patients exhibited worse gambling task performance than PD-DBS patients with stimulation off.
  • A significant interaction between performance and medication was observed.
  • DBS stimulation being turned on reduced the performance differences in impulsivity.

Conclusions:

  • Medication dosage is a primary driver of impulsive behavior differences in Parkinson's disease patients.
  • While DBS may have a slight negative impact on impulsivity, its potential to reduce DA dosage may ultimately improve impulse control.