Stimulation-induced transient nonmotor psychiatric symptoms following subthalamic deep brain stimulation in patients with Parkinson's disease: Association with clinical outcomes and neuroanatomical correlates

Osama A. Abulseoud, Aimen Kasasbeh, Hoon Ki Min, Julie A. Fields, Susannah J. Tye, Stephan Goerss, Emily J. Knight, Shirlene M. Sampson, Bryan T. Klassen, Joseph Y. Matsumoto, Cynthia Stoppel, Kendall H. Lee, Mark A. Frye

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)93-101
Number of pages9
JournalStereotactic and Functional Neurosurgery
Volume94
Issue number2
DOIs
StatePublished - May 1 2016

Bibliographical note

Funding Information:
We would like to thank Ms. Veneliza Salcedo for making the illustration. This work is supported by a grant from NIH/NCRR CTSA KL2 (RR024151; to O.A.A.) and the Mayo Foundation (to M.A.F.).

Keywords

  • Deep brain stimulation
  • Parkinson's disease
  • Psychiatric symptoms
  • Subthalamic nucleus

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