title: Acute changes in mood induced by subthalamic deep brain stimulation in Parkinson disease are modulated by psychiatric diagnosis.
abstract: BACKGROUND
  Deep brain stimulation of the subthalamic nucleus (STN DBS) reduces Parkinson disease (PD) motor symptoms but has unexplained, variable effects on mood.
  
  
  OBJECTIVE
  The study tested the hypothesis that pre-existing mood and/or anxiety disorders or increased symptom severity negatively affects mood response to STN DBS.
  
  
  METHODS
  Thirty-eight PD participants with bilateral STN DBS and on PD medications were interviewed with Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID) and completed Beck Depression Inventory (BDI) and Spielberger State Anxiety Inventory (SSAI) self-reports. Subsequently, during OFF and optimal ON (clinical settings) STN DBS conditions and while off PD medications, motor function was assessed with the United Parkinson Disease Rating Scale (UPDRS, part III), and participants rated their mood with Visual Analogue Scales (VAS), and again completed SSAI. VAS mood variables included anxiety, apathy, valence and emotional arousal.
  
  
  RESULTS
  STN DBS improved UPDRS scores and mood. Unexpectedly, PD participants diagnosed with current anxiety or mood disorders experienced greater STN DBS-induced improvement in mood than those diagnosed with remitted disorders or who were deemed as having never met threshold criteria for diagnosis. BDI and SSAI scores did not modulate mood response to STN DBS, indicating that clinical categorical diagnosis better differentiates mood response to STN DBS than self-rated symptom severity. SCID diagnosis, BDI and SSAI scores did not modulate motor response to STN DBS.
  
  
  CONCLUSIONS
  PD participants diagnosed with current mood or anxiety disorders are more sensitive to STN DBS-induced effects on mood, possibly indicating altered basal ganglia circuitry in this group.
authors.affiliation: Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Eisenstein
authors.affiliation: College of Arts and Sciences, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Dewispelaere
authors.affiliation: Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Meghan C
authors.initials: MC
authors.lastname: Campbell
authors.affiliation: Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Lugar
authors.affiliation: Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA; Department of Anatomy & Neurobiology, Washington University in St. Louis, St. Louis, MO, USA; Division of Biology and Biomedical Sciences, Washington University in St. Louis, St. Louis, MO, USA; Programs in Physical Therapy and Occupational Therapy, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Joel S
authors.initials: JS
authors.lastname: Perlmutter
authors.affiliation: Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA; Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA; Department of Anatomy & Neurobiology, Washington University in St. Louis, St. Louis, MO, USA; Division of Biology and Biomedical Sciences, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Black
authors.affiliation: Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA; Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA; Division of Biology and Biomedical Sciences, Washington University in St. Louis, St. Louis, MO, USA. Electronic address: tammy@wustl.edu.
authors.forename: Tamara
authors.initials: T
authors.lastname: Hershey
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D010300:Parkinson Disease / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D057566:Self Report; D016037:Single-Blind Method; D020531:Subthalamic Nucleus
keywords: Anxiety disorder; Deep brain stimulation; Mood; Mood disorder; Parkinson disease; Subthalamic nucleus