title: Impulse control behaviours in patients with Parkinson's disease after subthalamic deep brain stimulation: de novo cases and 3-year follow-up.
abstract: OBJECTIVE
  To document the occurrence of impulse control behaviours (ICBs) in patients with Parkinson's disease after 3 years of continuous deep brain stimulation (DBS) of the subthalamic nucleus (STN).
  
  
  METHODS
  Detailed neurological and ICB assessments were performed before STN DBS and up to 3 years after implant.
  
  
  RESULTS
  13 out of 56 patients (23.2%) had ICBs at baseline; they took higher doses of dopamine agonists (DAA). Three years after implant 11 had fully remitted with a 60.8% reduction of DAA medication; the remaining two, who had a similar medication reduction, had only compulsive eating, having recovered from hypersexuality. Six of the 43 patients without ICBs at baseline (14%) developed transient de novo ICBs after implant; none of them had ICBs at the 3-year observation.
  
  
  CONCLUSIONS
  ICBs were abolished in patients 3 years after STN DBS and DAA dosages were lowered. New ICBs may occur after implant and are transient in most cases. Compulsive eating may be specifically related to STN stimulation.
authors.affiliation: Neurologia I, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Amami
authors.affiliation: Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Dekker
authors.affiliation: Neurologia I, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Piacentini
authors.affiliation: Neurologia I, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ferré
authors.affiliation: Neurologia I, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
authors.forename: L M
authors.initials: LM
authors.lastname: Romito
authors.affiliation: Neurochirurgia III, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Franzini
authors.affiliation: Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: E M J
authors.initials: EM
authors.lastname: Foncke
authors.affiliation: Neurologia I, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy Istituto di Neurologia, Università Cattolica del Sacro Cuore, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Albanese
mesh_terms: D046690:Deep Brain Stimulation; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D011446:Prospective Studies; D020531:Subthalamic Nucleus / Q000502:physiology*
keywords: Behavioural Disorder; Parkinson's Disease; Surgery