Judith A Boel1, Vincent J J Odekerken2, Ben A Schmand3, Gert J Geurtsen4, Danielle C Cath5, Martijn Figee6, Pepijn van den Munckhof7, Rob J de Haan8, P Richard Schuurman9, Rob M A de Bie10. 1. Department of Neurology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands; Department of Psychology, University of Amsterdam, PO Box 19268, 1000 GG, Amsterdam, The Netherlands. Electronic address: j.a.boel@amc.uva.nl. 2. Department of Neurology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: v.j.odekerken@amc.uva.nl. 3. Department of Psychology, University of Amsterdam, PO Box 19268, 1000 GG, Amsterdam, The Netherlands; Department of Medical Psychology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: b.schmand@amc.uva.nl. 4. Department of Medical Psychology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: g.j.geurtsen@amc.uva.nl. 5. Altrecht Academic Anxiety Center, Utrecht, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, PO Box 80125, 3508 TC, Utrecht, The Netherlands. Electronic address: cath@xs4all.nl. 6. Department of Psychiatry, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: m.figee@amc.uva.nl. 7. Department of Neurosurgery, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: p.vandenmunckhof@amc.uva.nl. 8. Clinical Research Unit, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: r.j.dehaan@amc.uva.nl. 9. Department of Neurosurgery, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: p.r.schuurman@amc.uva.nl. 10. Department of Neurology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: r.m.debie@amc.uva.nl.
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.
RCT Entities:
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.
Authors: Tomas Cartmill; David Skvarc; Richard Bittar; Jane McGillivray; Michael Berk; Linda K Byrne Journal: Neuropsychol Rev Date: 2021-02-19 Impact factor: 7.444
Authors: Marc Baertschi; Nicolas Favez; João Flores Alves Dos Santos; Michalina Radomska; François Herrmann; Pierre Burkhard; Alessandra Canuto; Kerstin Weber Journal: J Clin Psychol Med Settings Date: 2019-12
Authors: Melissa Deanna Shepard; Kate Perepezko; Martijn P G Broen; Jared Thomas Hinkle; Ankur Butala; Kelly A Mills; Julie Nanavati; Nicole Mercado Fischer; Paul Nestadt; Gregory Pontone Journal: J Neurol Neurosurg Psychiatry Date: 2019-01-19 Impact factor: 10.154