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Management of impulse control disorders with deep brain stimulation: A double-edged sword
Chayut Kasemsuk1, Genko Oyama2, Nobutaka Hattori2
1Department of Neurology, Juntendo University, Faculty of Medicine, Tokyo, Japan; Department of Neurology, Prasat Neurological Institute, Bangkok, Thailand.
Journal of the Neurological Sciences
|January 28, 2017
Summary
Deep brain stimulation (DBS) for Parkinson's disease can impact impulse control disorders (ICDs). While DBS may improve some ICDs by reducing medication, it can also worsen or cause new ICDs, affecting patient quality of life.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Deep brain stimulation (DBS) is a surgical treatment for advanced Parkinson's disease (PD), primarily targeting motor fluctuations.
- Non-motor symptoms, including impulse control disorders (ICDs), can be significantly affected by DBS.
- ICDs, characterized by behaviors like pathological gambling and compulsive shopping, negatively impact the quality of life in PD patients.
Purpose of the Study:
- To review the complex impact of DBS on impulse control disorders (ICDs) in Parkinson's disease patients.
- To identify factors associated with positive responses to DBS regarding ICDs.
- To determine risk factors for developing de novo ICDs after DBS and propose management strategies.
Main Methods:
- Literature review of studies investigating DBS effects on ICDs in Parkinson's disease.
- Analysis of factors influencing ICDs pre- and post-DBS.
- Synthesis of evidence regarding medication reduction and ICDs.
Main Results:
- The effect of DBS on ICDs in Parkinson's disease is controversial, with potential for both improvement and worsening.
- Medication reduction facilitated by DBS may alleviate some ICD symptoms.
- New-onset ICDs (de novo ICDs) can emerge after DBS implantation.
Conclusions:
- DBS has a variable effect on impulse control disorders in Parkinson's disease.
- Careful patient selection and management strategies are crucial to mitigate risks and optimize outcomes.
- Further research is needed to refine management protocols for ICDs in the context of DBS therapy.
