Subthalamic deep brain stimulation and impulse control in Parkinson’s disease
Article first published online: 19 FEB 2009
© 2009 The Author(s). Journal compilation © 2009 EFNS
European Journal of Neurology
Volume 16, Issue 4, pages 493–497, April 2009
How to Cite
Hälbig, T. D., Tse, W., Frisina, P. G., Baker, B. R., Hollander, E., Shapiro, H., Tagliati, M., Koller, W. C. and Olanow, C. W. (2009), Subthalamic deep brain stimulation and impulse control in Parkinson’s disease. European Journal of Neurology, 16: 493–497. doi: 10.1111/j.1468-1331.2008.02509.x
- Issue published online: 19 MAR 2009
- Article first published online: 19 FEB 2009
- Received 26 September 2008 Accepted 20 October 2008
- deep brain stimulation;
- Parkinson’s disease;
- subthalamic nucleus
Background and purpose: Experimental studies suggest that deep brain stimulation (DBS) of the subthalamic nucleus (STN) induces impulsivity in patients with Parkinson’s disease (PD). The purpose of this study was to assess various measures of impulse control in PD patients with STN DBS in comparison to patients receiving medical therapy.
Methods: In a cross-sectional evaluation, 53 consecutively eligible patients were assessed for impulsivity with the Barratt Impulsiveness Scale, for impulse control disorders (ICDs) using the Minnesota Impulsive Disorders Interview, and for obsessive–compulsive symptoms using the Maudsley Obsessional-Compulsive Inventory.
Results: Independent samples t-tests revealed that compulsivity scores were not different between DBS patients and patients without DBS. However, impulsivity scores were significantly higher in DBS patients. Additionally, ICDs were observed in 3 of 16 (19%) DBS patients and in 3 of 37 (8%) medically treated patients. No association was found between the use of dopamine agonists and impulsivity in DBS patients.
Conclusions: Our data suggest that screening for impulsivity and ICDs should be performed prior to DBS, and that patients should be monitored for these problems during follow-up. Prospective trials are needed to confirm the findings of this exploratory study and to elucidate the reasons of a possible induction of impulsivity by STN DBS.