Impact of STN-DBS on mood, drive, anhedonia and risk of psychiatric side-effects in the population of PD patients.
BACKGROUND
DBS is a surgical method of choice for various movement disorders, especially for Parkinson's disease (PD). Many publications showing improvement in motor symptoms and quality of life have been presented while there is little comprehensive research evaluation of the impact of DBS on mental state and psychiatric side-effects.


OBJECTIVE
The purpose of this study was to assess the impact of DBS on mood, drive, anhedonia and psychotic symptoms in the group of PD patients.


METHODS
60 patients with PD were treated with STN-DBS. Mental state and psychiatric side effects were assessed with the use of MADRS, HADRS, BDI, BPRS, YMS, SHAPS, CGI and PGI rating scales. Evaluation was performed five times in the period from the day before surgery to six months after implantation of the DBS.


RESULTS
This study showed an improvement of mood, which has followed within a month after the start of stimulation and manifested in MADRS, HADRS, BDI scores reduction. The trend towards improvement was maintained over the following 6months. No manic episodes appeared, 2 cases of mild hypomania were observed. Psychotic symptoms occurred in 1 patient. Anhedonia reduction observed during the first 30days after initiating the stimulation persisted in the assessment six months after implantation of the DBS.


CONCLUSIONS
The survey results confirm the effect of stimulation on mood, drive, ability to feel pleasure. Psychiatric side effects such as phase change were rare and mild, while psychotic symptoms that occurred in one patient ware manageable through medication. Further intensive research in this topic are required.
Institute of Psychiatry and Neurology, Department of Affective Disorders, Poland. Electronic address: aantosik@ipin.edu.pl.
Anna
A
Antosik-Wójcińska
Institute of Psychiatry and Neurology, Department of Affective Disorders, Poland.
Łukasz
Ł
Święcicki
Institute of Psychiatry and Neurology, Poland.
Monika
M
Dominiak
Institute of Psychiatry and Neurology, Department of Neurosurgery, Poland.
Emilia
E
Sołtan
Institute of Psychiatry and Neurology, Poland; Department of Psychiatry Medical University of Warsaw, Warsaw, Poland.
Przemyslaw
P
Bieńkowski
Institute of Psychiatry and Neurology, Department of Neurosurgery, Poland.
Tomasz
T
Mandat
D000339:Affect / Q000502:physiology*; D000368:Aged; D059445:Anhedonia / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*; D010300:Parkinson Disease / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D020531:Subthalamic Nucleus / Q000502:physiology*
Anhedonia; Brain stimulation; DBS; Depression; Mania; Non-motor symptoms; Parkinson's disease; Psychosis