Cognitive and psychiatric outcome 3 years after globus pallidus pars interna or subthalamic nucleus deep brain stimulation for Parkinson's disease.
Effects on non-motor symptoms, mainly cognitive and psychiatric side effects, could influence the decision for either globus pallidus pars interna (GPi) or subthalamic nucleus (STN) deep brain stimulation (DBS) for patients with Parkinson's disease (PD).



1) To compare cognitive and psychiatric outcomes 3 years after GPi DBS versus STN DBS, and 2) to report on occurrence of suicidal ideation, psychiatric diagnoses, social functioning, and marital satisfaction 3 years after DBS.



Patients were randomized to receive GPi DBS (n = 65) or STN DBS (n = 63). Standardized assessments were performed at baseline, 1 year, and 3 years. We used linear mixed model analyses to investigate between-group differences on the Mattis Dementia Rating Scale (MDRS), neuropsychological tests, and psychiatric questionnaires 3 years after DBS.



Eighty-seven patients (68%) completed at least one neuropsychological test after 3 years. No significant between-group differences were found on the MDRS (p = 0.61), neuropsychological tests (p-values between 0.17 and 0.87), and psychiatric questionnaires (p-values between 0.23 and 0.88) 3 years after DBS. The Mini International Neuropsychiatric Interview did not indicate a substantial number of psychiatric diagnoses after 3 years. Social functioning and marital satisfaction were comparable in both groups.



Three years after GPi DBS and STN DBS no pronounced between-group differences on measures of cognitive and psychiatric functioning could be demonstrated. Overall, cognitive and psychiatric outcome 3 years after DBS do not provide a clear direction for clinicians when considering which of these two surgical targets to choose.
Department of Neurology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands; Department of Psychology, University of Amsterdam, PO Box 19268, 1000 GG, Amsterdam, The Netherlands. Electronic address: j.a.boel@amc.uva.nl.
Judith A
JA
Boel
Department of Neurology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: v.j.odekerken@amc.uva.nl.
Vincent J J
VJ
Odekerken
Department of Psychology, University of Amsterdam, PO Box 19268, 1000 GG, Amsterdam, The Netherlands; Department of Medical Psychology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: b.schmand@amc.uva.nl.
Ben A
BA
Schmand
Department of Medical Psychology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: g.j.geurtsen@amc.uva.nl.
Gert J
GJ
Geurtsen
Altrecht Academic Anxiety Center, Utrecht, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, PO Box 80125, 3508 TC, Utrecht, The Netherlands. Electronic address: cath@xs4all.nl.
Danielle C
DC
Cath
Department of Psychiatry, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: m.figee@amc.uva.nl.
Martijn
M
Figee
Department of Neurosurgery, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: p.vandenmunckhof@amc.uva.nl.
Pepijn
P
van den Munckhof
Clinical Research Unit, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: r.j.dehaan@amc.uva.nl.
Rob J
RJ
de Haan
Department of Neurosurgery, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: p.r.schuurman@amc.uva.nl.
P Richard
PR
Schuurman
Department of Neurology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: r.m.debie@amc.uva.nl.
Rob M A
RM
de Bie
D000368:Aged; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy*; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D005917:Globus Pallidus / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome
Cognition; Deep brain stimulation; Parkinson's disease; Psychiatry; Randomized controlled trial