Aryun Kim1, Young Eun Kim2, Han-Joon Kim1, Ji Young Yun3, Hui-Jun Yang4, Woong-Woo Lee5, Chae Won Shin6, Hyeyoung Park7, Yu Jin Jung8, Ahro Kim9, Gwanhee Ehm10, Yoon Kim1, Mihee Jang11, Beomseok Jeon12. 1. Department of Neurology, Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. 2. Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea. 3. Department of Neurology, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea. 4. Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. 5. Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea. 6. Department of Neurology, Kyung Hee University Medical Center, Seoul, South Korea. 7. Department of Neurology, Seoul Central Clinic, Seoul, South Korea. 8. Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, South Korea. 9. Department of Neurology, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea. 10. Department of Neurology, National Medical Center, Seoul, South Korea. 11. Department of Neurology, Jesus Hospital, Jeonju, South Korea. 12. Department of Neurology, Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: brain@snu.ac.kr.
Abstract
INTRODUCTION: Previous studies have reported improvement of impulse control disorders (ICDs) after subthalamic nucleus (STN) deep brain stimulation (DBS) as well as some de novo ICDs. However, it is not clear how STN DBS changes ICDs in the long-term. METHODS MATERIALS: Eighty-nine patients with Parkinson's disease (PD) who had received a bilateral STN DBS from 2005 to 2009 and were included in our previous study were followed for 7 years with the modified Minnesota Impulsive Disorders Interview (mMIDI). Their mMIDI scores, medication, and frontal function tests measured preoperatively and at 1 and 7 years postoperatively were compared. RESULTS: A total of 61 patients were analyzed after excluding 10 and 18 patients due to death and lost to follow-up, respectively. The numbers of the patients with an ICD at each point were 8, 10, and 7, respectively. All preoperative ICDs disappeared after DBS. De novo ICDs within 1 year after DBS disappeared except for 1 patient. Six of the seven patients, who reported ICDs 7 years after the DBS developed that ICD between 1 and 7 years. Their total levodopa equivalent daily dose (LEDD) and dopamine agonist dose were not higher compared to the other 54 patients without ICDs. There was no correlation with the frontal lobe dysfunction and the electrode position in the subthalamus. CONCLUSION: STN DBS improves baseline ICDs and results in the development of "transient" de novo ICDs in the short-term. In addition, there is a unique group of the patients who develop ICDs a long time after DBS.
INTRODUCTION: Previous studies have reported improvement of impulse control disorders (ICDs) after subthalamic nucleus (STN) deep brain stimulation (DBS) as well as some de novo ICDs. However, it is not clear how STN DBS changes ICDs in the long-term. METHODS MATERIALS: Eighty-nine patients with Parkinson's disease (PD) who had received a bilateral STN DBS from 2005 to 2009 and were included in our previous study were followed for 7 years with the modified Minnesota Impulsive Disorders Interview (mMIDI). Their mMIDI scores, medication, and frontal function tests measured preoperatively and at 1 and 7 years postoperatively were compared. RESULTS: A total of 61 patients were analyzed after excluding 10 and 18 patients due to death and lost to follow-up, respectively. The numbers of the patients with an ICD at each point were 8, 10, and 7, respectively. All preoperative ICDs disappeared after DBS. De novo ICDs within 1 year after DBS disappeared except for 1 patient. Six of the seven patients, who reported ICDs 7 years after the DBS developed that ICD between 1 and 7 years. Their total levodopa equivalent daily dose (LEDD) and dopamine agonist dose were not higher compared to the other 54 patients without ICDs. There was no correlation with the frontal lobe dysfunction and the electrode position in the subthalamus. CONCLUSION:STN DBS improves baseline ICDs and results in the development of "transient" de novo ICDs in the short-term. In addition, there is a unique group of the patients who develop ICDs a long time after DBS.
Authors: Dan Piña-Fuentes; Martijn Beudel; Simon Little; Peter Brown; D L Marinus Oterdoom; J Marc C van Dijk Journal: BMJ Open Date: 2019-06-14 Impact factor: 2.692
Authors: Robert S Eisinger; Adolfo Ramirez-Zamora; Samuel Carbunaru; Brandon Ptak; Zhongxing Peng-Chen; Michael S Okun; Aysegul Gunduz Journal: Front Neurol Date: 2019-02-26 Impact factor: 4.003
Authors: Ji Won Han; Yebin D Ahn; Won-Seok Kim; Cheol Min Shin; Seong Jin Jeong; Yoo Sung Song; Yun Jung Bae; Jong-Min Kim Journal: J Korean Med Sci Date: 2018-11-01 Impact factor: 2.153