Cognitive and psychiatric outcome 3 years after globus pallidus pars interna or subthalamic nucleus deep brain stimulation for Parkinson's disease. (December 2016)

• Record Type: Journal Article
• Authors: Odekerken, Vincent J.J.; Boel, Judith A.; van Laar, Teus; van Dijk, J.M.C.; Mosch, Arne; Hoffmann, Carel F.E.; Nijssen, Peter C.G.; van Asseldonk, T.; Beute, Guus N.; van Vugt, Jeroen P.P.; Lenders, Mathieu W.P.M.; Fiorella Contarino, M.; Bour, Lo J.; Geurtsen, Gert J.; van den Munckhof, Pepijn; Schmand, Ben A.; de Haan, Rob J.; Schuurman, P. Richard; de Bie, Rob M.A.; Boel, Judith A.; Odekerken, Vincent J.J.; Schmand, Ben A.; Geurtsen, Gert J.; Cath, Danielle C.; Figee, Martijn; van den Munckhof, Pepijn; de Haan, Rob J.; Schuurman, P. Richard; de Bie, Rob M.A.
• Is Part Of: Parkinsonism & related disorders. Volume 33(2016)
• Page Start: 90
• Page End: 95
• Publication Date: 2016-12
• Subjects: Parkinson's disease -- Deep brain stimulation -- Cognition -- Psychiatry -- Randomized controlled trial; DBS Deep brain stimulation -- GPi Globus pallidus pars interna -- STN Subthalamic nucleus -- PD Parkinson's disease -- MDRS Mattis Dementia Rating Scale; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2016.09.018
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Background: 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). Objective: 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. Methods: 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. Results: 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. Conclusions: 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. Highlights: We compared cognitive and psychiatric outcomes 3 years after GPi and STN DBS. No significant differences were found on cognitive and psychiatric outcomes. Descriptive reporting of the MINI and psychosocial outcomes were comparable. Cognitive and psychiatric outcome do not provide a clear direction for a DBS target.