title: Subjectively perceived personality and mood changes associated with subthalamic stimulation in patients with Parkinson's disease.
abstract: BACKGROUND
  Clinical and ethical implications of personality and mood changes in Parkinson's disease (PD) patients treated with subthalamic deep brain stimulation (STN-DBS) are under debate. Although subjectively perceived personality changes are often mentioned by patients and caregivers, few empirical studies concerning these changes exist. Therefore, we analysed subjectively perceived personality and mood changes in STN-DBS PD patients.
  
  
  METHODS
  In this prospective study of the ELSA-DBS group, 27 PD patients were assessed preoperatively and 1 year after STN-DBS surgery. Two categories, personality and mood changes, were analysed with semi-structured interviews. Patients were grouped into personality change yes/no, as well as positive/negative mood change groups. Caregivers were additionally interviewed about patients' personality changes. Characteristics of each group were assessed with standard neurological and psychiatric measurements. Predictors for changes were analysed.
  
  
  RESULTS
  Personality changes were perceived by six of 27 (22%) patients and by 10 of 23 caregivers (44%). The preoperative hypomania trait was a significant predictor for personality change perceived by patients. Of 21 patients, 12 (57%) perceived mood as positively changed. Higher apathy and anxiety ratings were found in the negative change group.
  
  
  CONCLUSIONS
  Our results show that a high proportion of PD patients and caregivers perceived personality changes under STN-DBS, emphasizing the relevance of this topic. Mood changed in positive and negative directions. Standard measurement scales failed to adequately reflect personality or mood changes subjectively perceived by patients. A more individualized preoperative screening and preparation for patients and caregivers, as well as postoperative support, could therefore be useful.
authors: Department of Neurology,University of Cologne,Cologne,Germany.
authors: C J
authors: CJ
authors: Lewis
authors: Department of Neurology,University of Cologne,Cologne,Germany.
authors: F
authors: F
authors: Maier
authors: Research Unit Ethics, Institute for the History of Medicine and Medical Ethics,University of Cologne,Cologne,Germany.
authors: N
authors: N
authors: Horstkötter
authors: Department of Neurology,University of Cologne,Cologne,Germany.
authors: A
authors: A
authors: Zywczok
authors: Research Unit Ethics, Institute for the History of Medicine and Medical Ethics,University of Cologne,Cologne,Germany.
authors: K
authors: K
authors: Witt
authors: Department of Neurology,University of Cologne,Cologne,Germany.
authors: C
authors: C
authors: Eggers
authors: Institute of Neuroscience,Newcastle University,Newcastle upon Tyne,UK.
authors: T D
authors: TD
authors: Meyer
authors: Department of Neurology,University of Cologne,Cologne,Germany.
authors: T A
authors: TA
authors: Dembek
authors: Department of Stereotaxy and Functional Neurosurgery,University of Cologne,Cologne,Germany.
authors: M
authors: M
authors: Maarouf
authors: Movement Disorders Unit, Department of Psychiatry and Neurology,University Hospital Center (CHU) of Grenoble,Grenoble,France.
authors: E
authors: E
authors: Moro
authors: Department of Psychiatry,University of Toronto, University Health Network,Toronto,Canada.
authors: M
authors: M
authors: Zurowski
authors: Research Unit Ethics, Institute for the History of Medicine and Medical Ethics,University of Cologne,Cologne,Germany.
authors: C
authors: C
authors: Woopen
authors: Department of Psychiatry and Psychotherapy,University of Cologne,Cologne,Germany.
authors: J
authors: J
authors: Kuhn
authors: Department of Neurology,University of Cologne,Cologne,Germany.
authors: L
authors: L
authors: Timmermann
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D017028:Caregivers; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology* / Q000209:etiology; D010300:Parkinson Disease / Q000601:surgery; D010554:Personality Disorders / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D020530:Subthalamus