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J Neurol Surg A Cent Eur Neurosurg 2018; 79(02): 130-138
DOI: 10.1055/s-0037-1606354
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Deep Brain Stimulation in Patients with Parkinson's Disease: Effect on Psychiatric Symptoms and Quality of Life

Elisa Seijo Zazo
1   Psychiatry Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Fernando Seijo Fernandez
2   Neurosurgery Department, Medical Center of Asturias, Oviedo, Spain
,
Elena Santamarta Liebana
3   Radiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Antonio Saiz Ayala
3   Radiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Beatriz Lozano Aragoneses
4   Neurophysiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
,
Jose Maria Torres Campa
2   Neurosurgery Department, Medical Center of Asturias, Oviedo, Spain
,
Paz Garcia Portilla
5   Psychiatry Department, Medical Center of Asturias, Oviedo, Spain
,
Marco Alvarez Vega
6   Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
› Author Affiliations
Further Information

Publication History

06 December 2016

27 June 2017

Publication Date:
29 September 2017 (online)

Also available ateRefMedOne
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Abstract

Background and Study Aims To determine the effect on psychiatric symptoms and quality of life in 30 patients with Parkinson's disease (PD) treated with deep brain stimulation (DBS) of both subthalamic nuclei (STN) after 1 year of follow-up.

Material and Method We conducted a prospective 1-year follow-up study with a baseline assessment before and 6 and 12 months after surgery. The following were used as assessment instruments: the Bech-Rafaelsen Melancholia Scale (MES), the Bech-Rafaelsen Mania Scale (MAS), the Beck Scale for Suicidal Ideation (SSI), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Oviedo Sleep Questionnaire (OSQ), the 36-Item Short Form Health Survey (SF-36), the Unified Parkinson's Disease Rating Scale (UPDRS), the dose of levodopa, and the active contact stereotactic coordinates.

Results We recorded a clinical improvement between baseline with medication use (ON medication) and the results obtained at 6 and 12 months with medication use and stimulation (ON stimulation, ON medication) in MES and OSQ (p < 0.0001) and in SF-36 (p < 0.005). No changes were observed in MAS and SSI. There was a clinical improvement between baseline with ON medication and the results obtained at 12 months with ON stimulation, ON medication in Y-BOCS (p < 0.04). Also, there was a 53.3% reduction in levodopa at 6 months and a 54.7% reduction at 12 months after surgery (p < 0.0001). There was an improvement between baseline with OFF medication and the results obtained at 6 and 12 months OFF medication, ON stimulation (p < 0.0001) in UPDRS-III. There were no statistically significant differences between the initial and final active contact coordinates, or between stimulation parameters.

Conclusions DBS of the STN in patients with PD is associated with an improvement in psychiatric (affective and sleep-wake cycle) symptoms, clinical motor symptoms, and quality of life at 1 year after surgery.

Keywords

Parkinson's disease - psychiatric symptoms - quality of life - deep brain stimulation