Functional and dysfunctional impulsivities changes after subthalamic nucleus-deep brain stimulation in Parkinson...

Area of Science:

• Neuroscience
• Neurosurgery
• Psychiatry

Background:

• Parkinson's disease (PD) is a neurodegenerative disorder affecting motor control.
• Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a common treatment for PD.
• Impulsivity is a complex behavior that can be altered in PD and after STN-DBS.

Purpose of the Study:

• To investigate changes in functional impulsivity (FI) and dysfunctional impulsivity (DI) after STN-DBS in PD patients.
• To identify factors contributing to alterations in impulsivity dimensions post-STN-DBS.

Main Methods:

• Studied 33 PD patients before and 6 months after STN-DBS.
• Assessed motor impairment, medication, cognition, mood, and impulse control disorders.
• Utilized the Dickman Impulsivity Inventory to differentiate FI and DI.
• Analyzed DBS lead location on MRI within a histological atlas.

Main Results:

• Dysfunctional impulsivity (DI) significantly increased post-STN-DBS (P<0.001).
• Functional impulsivity (FI) scores remained unchanged.
• Increased DI was associated with lower preoperative Frontal Assessment Battery scores and left active contact in the ventral STN.

Conclusions:

• STN-DBS may worsen pathological impulsivity (DI) while preserving physiological impulsivity (FI).
• Ventral STN lead placement might favor an increase in dysfunctional impulsivity.
• Understanding these changes is crucial for managing PD patients undergoing STN-DBS.