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Somma T, Esposito F, Scala MR, Scelzo A, Baiano C, Patti S, Meglio V, Iasevoli F, Cavallo LM, Solari D, De Bartolomeis A, Cappabianca P, D’Urso G. Psychiatric Symptoms in Parkinson's Disease Patients before and One Year after Subthalamic Nucleus Deep Brain Stimulation Therapy: Role of Lead Positioning and Not of Total Electrical Energy Delivered. J Pers Med 2022; 12:jpm12101643. [PMID: 36294782 PMCID: PMC9605574 DOI: 10.3390/jpm12101643] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Parkinson’s disease (PD) patients may experience neuropsychiatric symptoms, including depression, anxiety, sleep disturbances, psychosis, as well as behavioral and cognitive symptoms during all the different stages of the illness. Deep Brain Stimulation (DBS) therapy has proven to be successful in controlling the motor symptoms of PD and its possible correlation with the occurrence or worsening of neuropsychiatric symptoms has been reported. We aimed to assess the neuropsychiatric symptoms of 14 PD patients before and after one year of Subthalamic Nucleus (STN)-DBS and to correlate the possible changes to the lead placement and to the total electrical energy delivered. We assessed PD motor symptoms, depression, anxiety, apathy, impulsivity, and suicidality using clinician- and/or self-administered rating scales and correlated the results to the lead position using the Medtronic SuretuneTM software and to the total electrical energy delivered (TEED). At the 12-month follow-up, the patients showed a significant improvement in PD symptoms on the UPDRS (Unified Parkinson’s disease Rating Scale) (−38.5%; p < 0.001) and in anxiety on the Hamilton Anxiety Rating Scale (HAM-A) (−29%; p = 0.041), with the most significant reduction in the physiological anxiety subscore (−36.26%; p < 0.001). A mild worsening of impulsivity was detected on the Barratt Impulsiveness Scale (BIS-11) (+9%; p = 0.048), with the greatest increase in the attentional impulsiveness subscore (+13.60%; p = 0.050). No statistically significant differences were found for the other scales. No correlation was found between TEED and scales’ scores, while the positioning of the stimulating electrodes in the different portions of the STN was shown to considerably influence the outcome, with more anterior and/or medial lead position negatively influencing psychiatric symptoms.
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Affiliation(s)
- Teresa Somma
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of NeuroSurgery, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Felice Esposito
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of NeuroSurgery, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
- Department of NeuroSciences and Reproductive and Odontostomatological Sciences, Division of NeuroSurgery, Federico II University of Naples, 80131 Naples, Italy
- Neurosurgery Unit, Federico II Medical Center, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-746 (ext. 2489)
| | - Maria Rosaria Scala
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of NeuroSurgery, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Antonio Scelzo
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of Psychiatry, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Cinzia Baiano
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of NeuroSurgery, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Sara Patti
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of Psychiatry, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Vincenzo Meglio
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of NeuroSurgery, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Felice Iasevoli
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of Psychiatry, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Luigi M. Cavallo
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of NeuroSurgery, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Domenico Solari
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of NeuroSurgery, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Andrea De Bartolomeis
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of Psychiatry, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Paolo Cappabianca
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of NeuroSurgery, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Giordano D’Urso
- Department of NeuroSciences and Reproductive and Dental Sciences, Division of Psychiatry, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
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