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Meyer M, Montel S, Colnat-Coulbois S, Frismand S, Llorca PM, Vidailhet P, Schwan R, Spitz E. Parkinson's Disease: Coping Strategies, Cognitive Restructuring and Deep Brain Stimulation. J Geriatr Psychiatry Neurol 2024:8919887241248831. [PMID: 38801752 DOI: 10.1177/08919887241248831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Less is known concerning the evolution of coping strategies before and after deep brain stimulation (DBS) in Parkinson's disease (PD) patients. METHODS In a randomized controlled trial, coping was measured with the neurological version of the CHIP (Coping with Health Injuries and Problem) and the BriefCOPE in PD patients before ( T1: DBS - 2 months) and after (T2: + 3 months, T3: + 6 months) DBS. Patients (N = 50, age 59 ± 5.7 years, disease duration 9.54 ± 3.7 years) were randomised in 3 groups: CRTG (preoperative psychological preparation with cognitive restructuring), PIG (preoperative non structured interviews), and CG (no psychological preparation). RESULTS Coping strategies are modulated by the time of evaluation. Some strategies are significantly more used preoperatively than postoperatively, as strategies about the research for information (CHIP: F = 16.14; P = .000; η2 = .095; BriefCOPE F = 5.71; P = .005; η2 = .066), emotional regulation (F = 3.29; P = .042; η2 = .029), and well-being searching (F = 4.59; P = .013; η2 = .043). Some other strategies appear more used post than preoperatively, as palliative coping (F = 5.57; P = .005; η2 = .064), humour (F = 3.35; P = .041; η2 = .0.35), and use of substance (F = 4.43; P = .015; η2 = .070). No other specific time, group or time per group interaction effect was found. CONCLUSION Coping strategies are crucial for PD patients to adapt to the evolution of their parkinsonian state. Their consideration should be more systematic in the neurosurgical process, particularly when neurological symptoms would remain after DBS. More insights are needed concerning the evolution of coping strategies through DBS and the impact of a preoperative psychotherapy over them in preoperative PD patients.
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Affiliation(s)
- Mylène Meyer
- Service de Neurologie, Hôpital Central, CHRU Nancy, Nancy, France
| | - Sébastien Montel
- Mission Hospital, Mission Viejo, CA, USA
- Université de Lorraine, UMR 1319 INSPIIRE, Équipe Psychologie de la Santé de Metz (EPSAM), Metz, France
| | - Sophie Colnat-Coulbois
- Département de Neurochirurgie, Hôpital Central, CHRU de Nancy, Nancy, France
- Université de Lorraine, Nancy, France
| | - Solène Frismand
- Service de Neurologie, Hôpital Central, CHRU Nancy, Nancy, France
| | | | | | - Raymund Schwan
- Université de Lorraine, Nancy, France
- Centre Psychothérapique de Nancy, Nancy, France
| | - Elisabeth Spitz
- Université de Lorraine, UMR 1319 INSPIIRE, Équipe Psychologie de la Santé de Metz (EPSAM), Metz, France
- Université de Lorraine, Nancy, France
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Boussac M, Harroch E, Barthelemy C, Ory-Magne F, Leung C, Fabbri M, Arbus C, Brefel-Courbon C. Personality and quality-of-life improvement after apomorphine infusion in Parkinson's disease. Brain Commun 2024; 6:fcae181. [PMID: 38846534 PMCID: PMC11154139 DOI: 10.1093/braincomms/fcae181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/17/2024] [Accepted: 05/24/2024] [Indexed: 06/09/2024] Open
Abstract
People with Parkinson's disease with motor fluctuations can be treated by continuous subcutaneous apomorphine infusion (CSAI) to reduce their symptoms. Nonetheless, factors are lacking to predict patients' quality-of-life amelioration after CSAI. This pilot study aimed to evaluate associations between personality dimensions and quality-of-life improvement after 6 months of CSAI. Thirty-nine people with Parkinson's disease awaiting CSAI were included. Linear regression models between 'Temperament and Character Inventory' personality dimensions at baseline and percentage of change in Parkinson's Disease Questionnaire-39 scores after 6 months of CSAI were realized (n = 35). The Temperament and Character Inventory was also compared between patients awaiting CSAI and patients awaiting deep brain stimulation of the sub-thalamic nucleus (n = 39 from the PREDI-STIM study). Higher reward dependence scores were associated with a better quality-of-life outcome after 6 months of CSAI, while self-directedness scores were associated with a better quality of life before CSAI (as opposed to harm avoidance, reward dependence and self-transcendence scores associated with a worse quality of life). Moreover, people with Parkinson's disease awaiting deep brain stimulation of the sub-thalamic nucleus had similar Temperament and Character Inventory dimensions compared to patients awaiting CSAI. People with Parkinson's disease with higher reward dependence scores at baseline had the best quality-of-life improvement after 6 months of CSAI. This finding could be used to better prepare and accompany people with Parkinson's disease during CSAI establishment. Moreover, this result could serve as an orientation factor to second-line treatments.
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Affiliation(s)
- Mathilde Boussac
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, 31024 Toulouse, France
| | - Estelle Harroch
- Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), 31024 Toulouse, NS-PARK/FCRIN Network, France
| | - Christel Barthelemy
- Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), 31024 Toulouse, NS-PARK/FCRIN Network, France
| | - Fabienne Ory-Magne
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, 31024 Toulouse, France
- Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), 31024 Toulouse, NS-PARK/FCRIN Network, France
| | - Clémence Leung
- Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), 31024 Toulouse, NS-PARK/FCRIN Network, France
| | - Margherita Fabbri
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, 31024 Toulouse, France
- Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), 31024 Toulouse, NS-PARK/FCRIN Network, France
| | - Christophe Arbus
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, 31024 Toulouse, France
- Psychiatry Department of the University Hospital of Toulouse, CHU Purpan, 31024 Toulouse, France
| | - Christine Brefel-Courbon
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, 31024 Toulouse, France
- Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), 31024 Toulouse, NS-PARK/FCRIN Network, France
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Lu W, Wang H, Lin S, Chang X, Wang J, Wu X, Yu X. The association between the fibrinogen-to-albumin ratio and delirium after deep brain stimulation surgery in Parkinson's disease. Front Med (Lausanne) 2024; 11:1381967. [PMID: 38707190 PMCID: PMC11069307 DOI: 10.3389/fmed.2024.1381967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/01/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Postoperative delirium (POD) remains one of the most prevalent neuropsychiatric complications after deep brain stimulation (DBS) surgery. The fibrinogen-to-albumin ratio (FAR) has been shown to significantly correlate with the prognosis of many diseases related to inflammation. However, the association between FAR and POD remains unclear. We aimed to explore the association between POD and FAR in patients with Parkinson's disease (PD) undergoing DBS surgery. Methods Patients with PD who underwent DBS surgery in our hospital were included in this retrospective study. FAR was calculated from the blood sample collected on admission. The association between baseline FAR and delirium after surgery was assessed by binary logistic regression analysis, interaction analysis, and stratified analyses. Results Of 226 patients, 37 (16.4%) suffered from delirium after surgery. The average age of the participants was 63.3 ± 7.2 years, and 51.3% were male patients. Multivariate logistic regression analysis indicated that patients in the highest FAR tertile had a higher risk of POD compared with patients in the lowest FAR tertile (OR = 3.93, 95% CI: 1.24 ~ 12.67). Subgroup analysis demonstrated that FAR and the preoperative Mini-Mental State Examination score (p = 0.013) had an association with delirium after surgery. Conclusion Our data suggest that a higher preoperative FAR was significantly associated with delirium after DBS surgery. FAR on admission is a useful candidate biomarker to identify patients with PD who are at a high risk of delirium following DBS surgery.
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Affiliation(s)
- Wenbin Lu
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University/Second Military Medical University, Shanghai, China
| | - Hui Wang
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University/Second Military Medical University, Shanghai, China
| | - Shengwei Lin
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University/Second Military Medical University, Shanghai, China
| | - Xinning Chang
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University/Second Military Medical University, Shanghai, China
| | - Jiali Wang
- Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Xi Wu
- Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Xiya Yu
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
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Zhou Y, Ma Y, Yu C, Chen Y, Ding J, Yu J, Zhou R, Wang X, Fan T, Shi C. Detection Analysis of Perioperative Plasma and CSF Reveals Risk Biomarkers of Postoperative Delirium of Parkinson's Disease Patients Undergoing Deep Brain Stimulation of the Subthalamic Nuclei. Clin Interv Aging 2022; 17:1739-1749. [PMID: 36474580 PMCID: PMC9719687 DOI: 10.2147/cia.s388690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
Objective This study aimed to explore possible biomarkers of postoperative delirium (POD) of Parkinson's disease (PD) patients received deep brain stimulation (DBS) of the subthalamic nuclei. Materials and methods This nested case control study analyzed perioperative plasma and cerebral spinal fluid (CSF) of patients (n = 40) who developed POD undergone DBS surgery (n = 10) and those who did not (n = 30). Blood sample was collected before surgery and on the first day postoperative, CSF sample was collected at the beginning of the operation. POD was assessed by the Confusion Assessment Method (CAM) twice a day between 7:00 am and 7:00 pm after the surgery until discharge. Plasma and CSF sample from the two groups were analyzed to investigate possible biomarkers for POD in PD patients. Results There was no difference between POD and Non-POD groups on the concentration of Interleukin 6 and Tumor Necrosis Factor-α in CSF, preoperative plasma and postoperative plasma. There was no difference between POD and Non-POD groups on the concentration of S100 calcium-binding protein β protein (S100β) and Neurofilament light chain (NFL) in preoperative plasma and postoperative plasma. The concentration of C-reactive protein (CRP), NFL and S100β were significant higher in POD group than non-POD group in CSF. The concentration of CRP was significantly higher in POD group than non-POD group in preoperative plasma and postoperative plasma. CSF concentration of S100β might be a potential biomarker for POD via the receiver operating characteristic curve analysis and the area under the curve value of 0.973. Conclusion For PD patients received DBS surgery, CSF S100β might be a marker for aiding detection of high-risk patients with delirium. This requires further confirmation in clinical trials.
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Affiliation(s)
- Yongde Zhou
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing, People’s Republic of China
| | - Yu Ma
- Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing, People’s Republic of China
| | - Cuiping Yu
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing, People’s Republic of China
| | - Yao Chen
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing, People’s Republic of China
| | - Jian Ding
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing, People’s Republic of China
| | - Jianfeng Yu
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing, People’s Republic of China
| | - Rongsong Zhou
- Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing, People’s Republic of China
| | - Xiaoxiao Wang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Ting Fan
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing, People’s Republic of China
| | - Chengmei Shi
- Department of Anesthesiology, Peking University Third Hospital, Beijing, People’s Republic of China,Correspondence: Chengmei Shi; Ting Fan, Email ;
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Association between Baseline Cognitive Score and Postoperative Delirium in Parkinson’s Disease Patients following Deep Brain Stimulation Surgery. PARKINSON'S DISEASE 2022; 2022:9755129. [PMID: 36338872 PMCID: PMC9635975 DOI: 10.1155/2022/9755129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/24/2022] [Accepted: 06/13/2022] [Indexed: 11/20/2022]
Abstract
Background Deep brain stimulation of the subthalamic nuclei (STN-DBS) is a standard treatment option for advanced Parkinson's disease (PD) patients. Delirium following DBS electrode implantation is common, by several studies, and cognitive impairment is a risk factor for developing postoperative delirium (POD). This prospective observational study was conducted to identify whether preoperative baseline cognitive status has an association with POD in PD patients undergoing DBS surgery. Methods Preoperatively, neuropsychiatric and neuropsychological assessments of the patients were performed including clinical dementia rating (CDR) score, instrumental activities of daily living (IADL) score, mini-mental state exam (MMSE) score, Montreal cognitive assessment (MoCA) score, Hamilton anxiety (HAMA) and Hamilton depression (HAMD) scores, and numerical cancellation test. POD was identified by the confusion assessment method (CAM) twice per day on postoperative day 1 until discharge. Results Twenty-seven (21.6%) of 125 patients developed POD. Among the variables screened, age, CDR score, MMSE score, and HAMA score were indicated to be independent influence factors of POD. The cutoff score, AUC, sensitivity, and specificity of age, CDR score, MMSE score, and HAMA score associated with POD was 58.5, 0.751, 92.6%, 52.0%; 0.5, 0.848, 77.8%, 91.8%; 27.5, 0.827, 88.9%, 62.2%; and 12.5, 0.706, 85.2%, 54.1%, respectively. Conclusions We observed age, CDR score, MMSE score, and HAMA score were independent influence factors of POD in PD patients who received DBS. It is necessary to assess the cognitive status of PD patients before surgery to identify high-risk patients.
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Zhou Y, Li Z, Ma Y, Yu C, Chen Y, Ding J, Yu J, Zhou R, Wang X, Liu T, Guo X, Fan T, Shi C. The Effect of Propofol versus Sevoflurane on Postoperative Delirium in Parkinson's Disease Patients Undergoing Deep Brain Stimulation Surgery: An Observational Study. Brain Sci 2022; 12:689. [PMID: 35741575 PMCID: PMC9221052 DOI: 10.3390/brainsci12060689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The selection of the maintenance of general anesthesia may affect the development of postoperative delirium (POD), notably for Parkinson's disease (PD) patients, due to their lower cognitive reserve. The present study was designed to compare the potential impact of propofol vs. sevoflurane based general anesthesia maintenance methods on the development of POD in PD patients following deep brain stimulation (DBS) surgery. METHODS A total of 125 PD patients who were scheduled to undergo DBS surgery were randomly divided into the propofol (n = 63) and the sevoflurane groups (n = 62). The patients in the two groups randomly received propofol- or sevoflurane-based general anesthesia. The Confusion Assessment Method (CAM) was employed by an investigator who was blinded to the anesthesia regimen and was administered twice per day from postoperative day 1 until discharge. RESULTS The incidence of POD was 22.22% (14/63) with propofol anesthesia and 20.97% (13/62) with sevoflurane anesthesia (p = 0.865). In addition, no difference was noted in the duration and severity of delirium between the propofol and sevoflurane groups. CONCLUSIONS In the present study, propofol- and sevoflurane-based general anesthesia exhibited comparable results with regard to the POD incidence in PD patients undergoing deep brain stimulation surgery.
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Affiliation(s)
- Yongde Zhou
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing 100040, China; (Y.Z.); (C.Y.); (Y.C.); (J.D.); (J.Y.)
| | - Zhengqian Li
- Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China; (Z.L.); (T.L.); (X.G.)
- Beijing Center of Quality Control and Improvement on Clinical Anesthesia, Beijing,100191, China
| | - Yu Ma
- Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing 100040, China; (Y.M.); (R.Z.)
| | - Cuiping Yu
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing 100040, China; (Y.Z.); (C.Y.); (Y.C.); (J.D.); (J.Y.)
| | - Yao Chen
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing 100040, China; (Y.Z.); (C.Y.); (Y.C.); (J.D.); (J.Y.)
| | - Jian Ding
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing 100040, China; (Y.Z.); (C.Y.); (Y.C.); (J.D.); (J.Y.)
| | - Jianfeng Yu
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing 100040, China; (Y.Z.); (C.Y.); (Y.C.); (J.D.); (J.Y.)
| | - Rongsong Zhou
- Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing 100040, China; (Y.M.); (R.Z.)
| | - Xiaoxiao Wang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China;
| | - Taotao Liu
- Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China; (Z.L.); (T.L.); (X.G.)
- Beijing Center of Quality Control and Improvement on Clinical Anesthesia, Beijing,100191, China
| | - Xiangyang Guo
- Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China; (Z.L.); (T.L.); (X.G.)
- Beijing Center of Quality Control and Improvement on Clinical Anesthesia, Beijing,100191, China
| | - Ting Fan
- Department of Anesthesiology, Tsinghua University Yuquan Hospital, Beijing 100040, China; (Y.Z.); (C.Y.); (Y.C.); (J.D.); (J.Y.)
| | - Chengmei Shi
- Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China; (Z.L.); (T.L.); (X.G.)
- Beijing Center of Quality Control and Improvement on Clinical Anesthesia, Beijing,100191, China
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