Nomogram for Predicting Depression Improvement after Deep Brain Stimulation for Parkinson's Disease

Area of Science:

• Neurology
• Neurosurgery
• Psychiatry

Background:

• Parkinson's disease (PD) is a common neurodegenerative disorder.
• Depression is a frequent non-motor symptom in PD patients.
• Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) is an effective PD treatment.

Purpose of the Study:

• To develop a predictive nomogram for depression improvement after STN-DBS in PD patients.
• To identify factors influencing depression outcome post-STN-DBS.
• To assess the nomogram's predictive accuracy and clinical utility.

Main Methods:

• Retrospective analysis of 103 PD patients undergoing STN-DBS.
• Hamilton Depression Rating Scale (HDRS) scores assessed 1 year post-surgery.
• Logistic regression analysis to identify predictors of depression improvement.
• Nomogram construction and validation using calibration plots and ROC analysis.

Main Results:

• Mean and median HDRS improvement rates were 13.1% and 33.3%.
• 70.8% of patients showed depression improvement; 23.3% worsened.
• Independent predictors for better depression improvement included age, preoperative PDQ, HARS, and HDRS scores.
• The nomogram demonstrated good discrimination (C-index=0.78) and calibration.

Conclusions:

• A validated nomogram can predict depression improvement 1 year after STN-DBS in Parkinson's disease patients.
• The nomogram aids in judging expected depression outcomes for PD patients receiving STN-DBS.
• This tool supports clinical decision-making regarding STN-DBS for managing depression in PD.