The trajectory of apathy after deep brain stimulation: from pre-surgery to 6 months post-surgery in Parkinson's disease.
Deep brain stimulation (DBS) has been associated with increased apathy in patients with PD, yet studies lack longitudinal data and have not assessed differences between sites of implantation (i.e. STN versus GPi). We assessed apathy prior to surgery and 6 months post-surgery using a longitudinal design-latent growth curve modeling. We hypothesized that apathy would increase post-surgery, and be related to subthalamic nucleus (versus globus pallidus interna) implantation. Forty-eight PD patients underwent unilateral surgery to either GPi or STN and completed the Apathy Scale prior to surgery and 2, 4, and 6 months post-surgery. Forty-eight matched PD controls completed the Apathy Scale at a 6-month interval. Results indicated apathy increased linearly from pre- to 6-months post-DBS by .66 points bi-monthly, while apathy in the control group did not change. There was no relationship between apathy and DBS site. Higher baseline depression was associated with higher baseline apathy, but not with change in apathy. Middle-aged adults (<65) had a steeper trajectory of apathy than older adults (≥ 65). Apathy trajectory was not related to motor severity, laterality of DBS, levodopa medication reduction, or motor changes after surgery.
Department of Clinical & Health Psychology, College of Public Health and Health, Professions, University of Florida, Box 100165, Gainesville, FL 32610, USA.
L
L
Kirsch-Darrow
L B
LB
Zahodne
M
M
Marsiske
M S
MS
Okun
K D
KD
Foote
D
D
Bowers
D000328:Adult; D000368:Aged; D057565:Apathy; D016009:Chi-Square Distribution; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D005260:Female; D005917:Globus Pallidus / Q000502:physiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000628:therapy; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D020531:Subthalamic Nucleus / Q000502:physiology; D016896:Treatment Outcome
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