Long-term effects of STN DBS on mood: psychosocial profiles remain stable in a 3-year follow-up.
BACKGROUND
Deep brain stimulation of the subthalamic nucleus significantly improves motor function in patients with severe Parkinson's disease. However, the effects on nonmotor aspects remain uncertain. The present study investigated the effects of subthalamic nucleus deep brain stimulation on mood and psychosocial functions in 33 patients with advanced Parkinson's disease in a three year follow-up.


METHODS
Self-rating questionnaires were administered to 33 patients prior to surgery as well as three, six, twelve and 36 months after surgery.


RESULTS
In the long run, motor function significantly improved after surgery. Mood and psychosocial functions transiently improved at one year but returned to baseline at 36 months after surgery. In addition, we performed cluster and discriminant function analyses and revealed four distinct psychosocial profiles, which remained relatively stable in the course of time. Two profiles featured impaired psychosocial functioning while the other two of them were characterized by greater psychosocial stability.


CONCLUSIONS
Compared to baseline no worsening in mood and psychosocial functions was found three years after electrode implantation. Moreover, patients can be assigned to four distinct psychosocial profiles that are relatively stable in the time course. Since these subtypes already exist preoperatively the extent of psychosocial support can be anticipatory adjusted to the patients' needs in order to enhance coping strategies and compliance. This would allow early detection and even prevention of potential psychiatric adverse events after surgery. Given adequate psychosocial support, these findings imply that patients with mild psychiatric disturbances should not be excluded from surgery.
Kaiser
Iris
I
Department of Neurosurgery, Medical University of Vienna, Austria. iris.kaiser@meduniwien.ac.at
Kryspin-Exner
Ilse
I
Brücke
Thomas
T
Volc
Dieter
D
Alesch
François
F
D000328:Adult; D000339:Affect / Q000502:physiology*; D000368:Aged; D001526:Behavioral Symptoms / Q000209:etiology / Q000628:therapy; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods*; D004567:Electrodes, Implanted / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010300:Parkinson Disease / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology*; D011788:Quality of Life / Q000523:psychology; D012919:Social Behavior; D013238:Stereotaxic Techniques / Q000009:adverse effects; D020531:Subthalamic Nucleus; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome