Stimulation-Induced Transient Nonmotor Psychiatric Symptoms following Subthalamic Deep Brain Stimulation in Patients with Parkinson's Disease: Association with Clinical Outcomes and Neuroanatomical Correlates.
The clinical and neurobiological underpinnings of transient nonmotor (TNM) psychiatric symptoms during the optimization of stimulation parameters in the course of subthalamic nucleus deep brain stimulation (STN-DBS) remain under intense investigation.



Forty-nine patients with refractory Parkinson's disease underwent bilateral STN-DBS implants and were enrolled in a 24-week prospective, naturalistic follow-up study. Patients who exhibited TNM psychiatric manifestations during DBS parameter optimization were evaluated for potential associations with clinical outcome measures.



Twenty-nine TNM+ episodes were reported by 15 patients. No differences between TNM+ and TNM- groups were found in motor outcome. However, unlike the TNM- group, TNM+ patients did not report improvement in subsyndromal depression or quality of life. TNM+ episodes were more likely to emerge during bilateral monopolar stimulation of the medial STN.



The occurrence of TNM psychiatric symptoms during optimization of stimulation parameters was associated with the persistence of subsyndromal depression and with lower quality of life ratings at 6 months. The neurobiological underpinnings of TNM symptoms are investigated yet remain difficult to explain.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn., USA.
Osama A
OA
Abulseoud
Aimen
A
Kasasbeh
Hoon-Ki
HK
Min
Julie A
JA
Fields
Susannah J
SJ
Tye
Stephan
S
Goerss
Emily J
EJ
Knight
Shirlene M
SM
Sampson
Bryan T
BT
Klassen
Joseph Y
JY
Matsumoto
Cynthia
C
Stoppel
Kendall H
KH
Lee
Mark A
MA
Frye
D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D003448:Crying / Q000523:psychology; D046690:Deep Brain Stimulation / Q000009:adverse effects* / Q000639:trends; D003863:Depression / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D020531:Subthalamic Nucleus / Q000033:anatomy & histology* / Q000601:surgery*; D016896:Treatment Outcome