Carla Piano1, Francesco Bove1,2, Tommaso Tufo3, Isabella Imbimbo1,4, Danilo Genovese1,2, Alessandro Stefani5, Massimo Marano6, Antonella Peppe7, Livia Brusa8, Rocco Cerroni5, Francesco Motolese6, Enrico Di Stasio9,10, Marianna Mazza11, Antonio Daniele1,2, Alessandro Olivi2,3, Paolo Calabresi1,2, Anna Rita Bentivoglio1,2. 1. Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 2. Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy. 3. Neurosurgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 4. Fondazione Don Carlo Gnocchi Onlus, Milan, Italy. 5. Department of System Medicine, Unità Operativa Semplice Dipartimentale (UOSD) Parkinson, University of Rome Tor Vergata, Rome, Italy. 6. Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy. 7. IRCCS Santa Lucia Foundation, Rome, Italy. 8. Neurology Unit, S. Eugenio Hospital, Rome, Italy. 9. Unit of Chemistry, Biochemistry and Clinical Molecular Biology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 10. Institute of Biochemistry and Clinical Biochemistry, Università Cattolica del Sacro Cuore, Rome, Italy. 11. Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Abstract
Background: The containment measures taken by Italian government authorities during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic caused the interruption of neurological activities of outpatient clinics. Vulnerable patients, as Parkinson's disease (PD) and dystonic patients with deep brain stimulation (DBS), may have an increased risk of chronic stress related to social restriction measures and may show a potential worsening of motor and psychiatric symptoms. Methods: This cross-sectional multicenter study was carried out during the SARS-CoV-2 pandemic and was based on a structured survey administered during a telephone call. The questionnaire was designed to gather motor and/or psychiatric effects of the lockdown and coronavirus disease 2019 (COVID-19) epidemiologic information in PD and dystonic patients with a functioning DBS implant. Results: One hundred four patients were included in the study, 90 affected by PD and 14 by dystonia. Forty-nine patients reported a subjective perception of worsening of global neurological symptoms (motor and/or psychiatric) related to the containment measures. In the multivariate analysis, having problems with the DBS device was the only independent predictor of motor worsening [odds ratio (OR) = 3.10 (1.22-7.91), p = 0.018]. Independent predictors of psychiatric worsening were instrumental activities of daily living (IADL) score [OR = 0.78 (0.64-0.95), p = 0.012] and problems with DBS [OR = 5.69 (1.95-16.62), p = 0.001]. Only one patient underwent nasopharyngeal swabs, both negative, and no patient received a diagnosis of COVID-19. Conclusions: Lockdown restriction measures were associated with subjective worsening of motor and psychiatric symptoms in PD and dystonic patients treated with DBS, and they may have exacerbated the burden of neurological disease and increased the chronic stress related to the DBS management.
Background: The containment measures taken by Italian government authorities during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic caused the interruption of neurological activities of outpatient clinics. Vulnerable patients, as Parkinson's disease (PD) and dystonicpatients with deep brain stimulation (DBS), may have an increased risk of chronic stress related to social restriction measures and may show a potential worsening of motor and psychiatric symptoms. Methods: This cross-sectional multicenter study was carried out during the SARS-CoV-2 pandemic and was based on a structured survey administered during a telephone call. The questionnaire was designed to gather motor and/or psychiatric effects of the lockdown and coronavirus disease 2019 (COVID-19) epidemiologic information in PD and dystonicpatients with a functioning DBS implant. Results: One hundred four patients were included in the study, 90 affected by PD and 14 by dystonia. Forty-nine patients reported a subjective perception of worsening of global neurological symptoms (motor and/or psychiatric) related to the containment measures. In the multivariate analysis, having problems with the DBS device was the only independent predictor of motor worsening [odds ratio (OR) = 3.10 (1.22-7.91), p = 0.018]. Independent predictors of psychiatric worsening were instrumental activities of daily living (IADL) score [OR = 0.78 (0.64-0.95), p = 0.012] and problems with DBS [OR = 5.69 (1.95-16.62), p = 0.001]. Only one patient underwent nasopharyngeal swabs, both negative, and no patient received a diagnosis of COVID-19. Conclusions: Lockdown restriction measures were associated with subjective worsening of motor and psychiatric symptoms in PD and dystonicpatients treated with DBS, and they may have exacerbated the burden of neurological disease and increased the chronic stress related to the DBS management.
Authors: Mustafa S Siddiqui; Joohi Jimenez-Shahed; Zoltan Mari; Benjamin L Walter; Sol De Jesus; Fedor Panov; Jason M Schwalb; Michele K York; Harini Sarva; John M Bertoni; Neepa Patel; Lin Zhang; James McInerney; Joshua M Rosenow Journal: Parkinsonism Relat Disord Date: 2021-10-18 Impact factor: 4.891