title: The Influence of Bilateral Subthalamic Nucleus Deep Brain Stimulation on Impulsivity and Prepulse Inhibition in Parkinson's Disease Patients.
abstract: BACKGROUND
  At least 14% of Parkinson disease (PD) patients develop impulse control disorders (ICDs). The pathophysiology behind these behaviors and the impact of deep brain stimulation in a real-life setting remain unclear.
  
  
  OBJECTIVE
  We prospectively examined the impact of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on ICDs in PD patients, as well as the relationship between impaired sensorimotor gaiting and impulsivity.
  
  
  METHODS
  Patients undergoing bilateral STN-DBS were assessed for ICDs preoperatively and 1-year postoperatively using a validated questionnaire (QUIP-RS). A subset of patients completed the Balloon Analogue Risk Task (BART) and auditory prepulse inhibition (PPI) testing.
  
  
  RESULTS
  Analysis revealed 12 patients had an improvement in score assessing ICDs ('good responders'; p = 0.006) while 4 had a worse or stable score ('poor responders'; p > 0.05). Good responders further exemplified a significant decrease in hypersexual behavior (p = 0.005) and binge eating (p = 0.01). Impaired PPI responses also significantly correlated with impulsivity in BART (r = -0.72, p = 0.044).
  
  
  CONCLUSIONS
  Following bilateral STN-DBS, 75% of our cohort had a reduction in ICDs, thus suggesting deep brain stimulation effectively manages ICDs in PD. The role of impaired PPI in predisposition to ICDs in PD warrants further investigation.
authors.affiliation: Department of Neurosurgery, Albany Medical College, Albany, N.Y., USA.
authors.forename: Lucy
authors.initials: L
authors.lastname: Gee
authors.forename: Heather
authors.initials: H
authors.lastname: Smith
authors.forename: Priscilla
authors.initials: P
authors.lastname: De La Cruz
authors.forename: Joannalee
authors.initials: J
authors.lastname: Campbell
authors.forename: Chris
authors.initials: C
authors.lastname: Fama
authors.forename: Jessica
authors.initials: J
authors.lastname: Haller
authors.forename: Adolfo
authors.initials: A
authors.lastname: Ramirez-Zamora
authors.forename: Jennifer
authors.initials: J
authors.lastname: Durphy
authors.forename: Era
authors.initials: E
authors.lastname: Hanspal
authors.forename: Eric
authors.initials: E
authors.lastname: Molho
authors.forename: Anne
authors.initials: A
authors.lastname: Barba
authors.forename: Damian
authors.initials: D
authors.lastname: Shin
authors.forename: Julie G
authors.initials: JG
authors.lastname: Pilitsis
mesh_terms: D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation; D004198:Disease Susceptibility; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007175:Impulsive Behavior / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D065808:Prepulse Inhibition / Q000502:physiology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000978:Antiparkinson Agents