Subthalamic deep brain stimulation and impulse control in Parkinson's disease.
OBJECTIVE
Experimental studies suggest that deep brain stimulation (DBS) of the subthalamic nucleus (STN) induces impulsivity in patients with Parkinson's disease (PD). The purpose of this study was to assess various measures of impulse control in PD patients with STN DBS in comparison to patients receiving medical therapy.


METHODS
In a cross-sectional evaluation, 53 consecutively eligible patients were assessed for impulsivity with the Barratt Impulsiveness Scale, for impulse control disorders (ICDs) using the Minnesota Impulsive Disorders Interview, and for obsessive-compulsive symptoms using the Maudsley Obsessional-Compulsive Inventory.


RESULTS
Independent samples t-tests revealed that compulsivity scores were not different between DBS patients and patients without DBS. However, impulsivity scores were significantly higher in DBS patients. Additionally, ICDs were observed in 3 of 16 (19%) DBS patients and in 3 of 37 (8%) medically treated patients. No association was found between the use of dopamine agonists and impulsivity in DBS patients.


CONCLUSIONS
Our data suggest that screening for impulsivity and ICDs should be performed prior to DBS, and that patients should be monitored for these problems during follow-up. Prospective trials are needed to confirm the findings of this exploratory study and to elucidate the reasons of a possible induction of impulsivity by STN DBS.
Hälbig
T D
TD
Fédération de Neurologie, Centre Hospitalier Universitaire Pitié-Salpêtrière, Paris, France. halbig.psl@gmail.com
Tse
W
W
Frisina
P G
PG
Baker
B R
BR
Hollander
E
E
Shapiro
H
H
Tagliati
M
M
Koller
W C
WC
Olanow
C W
CW
D000368:Aged; D003192:Compulsive Behavior / Q000209:etiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology*; D015259:Dopamine Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000503:physiopathology*
D015259:Dopamine Agents