Deep brain stimulation of the subthalamic nucleus improves sense of well-being in parkinson's disease§

Authors

  • Louise M. McDonald PhD,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
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  • Donna Page MSc,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
    Current affiliation:
    1. Ballito Medical Centre, The Well, Albertino Way, Ballito 4420, South Africa
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  • Leonora Wilkinson PhD,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
    2. Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
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  • Marjan Jahanshahi PhD

    Corresponding author
    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
    • Sobell Department of Motor Neuroscience and Movement Disorders (Box 146), Institute of Neurology, 33 Queen Square, London, WC1N 3BG
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  • Funding agencies: This work was supported by a postdoctoral fellowship from Parkinson's UK (to LW) and an NIH R01 grant (NS40862-02 to MJ).

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Deep brain stimulation of the subthalamic nucleus is an effective treatment for the motor symptoms of Parkinson's disease. Although a range of psychiatric and behavioral problems have been documented following deep brain stimulation, the short-term effects of subthalamic nucleus stimulation on patients' mood have only been investigated in a few studies. Our aim was to compare self-reported mood in Parkinson's patients with deep brain stimulation of the subthalamic nucleus ON versus OFF. Twenty-three Parkinson's patients with bilateral deep brain stimulation of the subthalamic nucleus and 11 unoperated Parkinson's patients completed a mood visual analogue scale twice. Operated patients were tested with deep brain stimulation of the subthalamic nucleus both ON and OFF. All were assessed on medication. The operated Parkinson's group reported feeling significantly better coordinated, stronger, and more contented with deep brain stimulation ON compared to OFF. Fourteen of the 16 mood scales changed in a positive direction when deep brain stimulation of the subthalamic nucleus was ON. When changes in motor scores were taken into account, the operated patients still reported feeling better-coordinated, but also less gregarious with stimulation ON. Unoperated Parkinson's patients showed no differences on any of these measures between their 2 ratings. Short-term changes in deep brain stimulation of the subthalamic nucleus have a small and mostly positive effect on mood, which may be partly related to improvements in motor symptoms. The implications for day-to-day management of patients with deep brain stimulation of the subthalamic nucleus are discussed. © 2012 Movement Disorder Society

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