Deep Brain Stimulation: In Search of Reliable Instruments for Assessing Complex Personality-Related Changes.
During the last 25 years, more than 100,000 patients have been treated with Deep Brain Stimulation (DBS). While human clinical and animal preclinical research has shed light on the complex brain-signaling disturbances that underpin e.g., Parkinson's disease (PD), less information is available when it comes to complex psychosocial changes following DBS interventions. In this contribution, we propose to more thoroughly investigate complex personality-related changes following deep brain stimulation through refined and reliable instruments in order to help patients and their relatives in the post-surgery phase. By pursuing this goal, we first outline the clinical importance DBS has attained followed by discussing problematic and undesired non-motor problems that accompany some DBS interventions. After providing a brief definition of complex changes, we move on by outlining the measurement problem complex changes relating to non-motor symptoms currently are associated with. The latter circumstance substantiates the need for refined instruments that are able to validly assess personality-related changes. After providing a brief paragraph with regard to conceptions of personality, we argue that the latter is significantly influenced by certain competencies which themselves currently play only a tangential role in the clinical DBS-discourse. Increasing awareness of the latter circumstance is crucial in the context of DBS because it could illuminate a link between competencies and the emergence of personality-related changes, such as new-onset impulse control disorders that have relevance for patients and their relatives. Finally, we elaborate on the field of application of instruments that are able to measure personality-related changes.
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, Zurich 8006, Switzerland. christian.ineichen@uzh.ch.
Christian
C
Ineichen
Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, Zurich 8091, Switzerland. Heide.baumann-vogel@usz.ch.
Heide
H
Baumann-Vogel
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, Zurich 8006, Switzerland. christen@ethik.uzh.ch.
Markus
M
Christen
competencies; deep brain stimulation; instruments; personality