Journal Home > Volume 10 , Issue 1
Objective:

This study aimed to determine the effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety and depression in Parkinson’s disease (PD) patients.

Methods:

The clinical data of 57 patients with PD who underwent bilateral STN-DBS between March and December 2018, were retrospectively analyzed. Patient scores on the Unified Parkinson’s Disease Rating Scale-Part III (UPDRS-Ⅲ), the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), and the Parkinson’s Disease Questionnaire (PDQ-39) were evaluated.

Results:

Patient evaluations took place preoperatively and at 1, 3, and 6-month follow-ups. The average patient improvement rates for HAM-A and HAM-D scores at the 6-month follow-up were 41.7% [interquartile range (IQR) 34.9%] and 37.5% (IQR 33.4%), respectively (both p < 0.001). There were positive correlations between both the rate of improvement in HAM-A scores and the rate of improvement in PDQ-39 scores (r = 0.538, p < 0.001), and between the rate of improvement in HAM-D scores and the rate of improvement in PDQ-39 scores (r = 0.404, p = 0.002) at the 6-month follow-up. HAM-A and HAM-D scores were positively correlated with the Parkinson’s Hoehn-Yahr disease stage (r = 0.296, p = 0.025; and r = 0.380, p = 0.004, respectively).

Conclusion:

Bilateral STN-DBS can improve symptoms of anxiety and depression in PD patients.


menu
Abstract
Full text
Outline
About this article

Therapeutic effects of subthalamic nucleus deep brain stimulation on anxiety and depression in Parkinson’s disease patients

Show Author's information Feng Zhang1Feng Wang2,3Cong-Hui Li1Ji-Wei Wang1Chun-Lei Han4Shi-Ying Fan4Shan-Quan Jing1Hong-Bo Jin1Lei Du1Wei Liu1Zi-Feng Wang1Ze-Yu Yin1Dong-Mei Gao4Yu-Jing Xing1Chen Yang1Jian-Guo Zhang4Fan-Gang Meng4,5,6,7( )
Department of Neurosurgery, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei, China
Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang, China
Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750004, Ningxia, China
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
Beijing Key Laboratory of Neurostimulation, Beijing 100070, China
Chinese Institute for Brain Research, Beijing 102206, China

Abstract

Objective:

This study aimed to determine the effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety and depression in Parkinson’s disease (PD) patients.

Methods:

The clinical data of 57 patients with PD who underwent bilateral STN-DBS between March and December 2018, were retrospectively analyzed. Patient scores on the Unified Parkinson’s Disease Rating Scale-Part III (UPDRS-Ⅲ), the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), and the Parkinson’s Disease Questionnaire (PDQ-39) were evaluated.

Results:

Patient evaluations took place preoperatively and at 1, 3, and 6-month follow-ups. The average patient improvement rates for HAM-A and HAM-D scores at the 6-month follow-up were 41.7% [interquartile range (IQR) 34.9%] and 37.5% (IQR 33.4%), respectively (both p < 0.001). There were positive correlations between both the rate of improvement in HAM-A scores and the rate of improvement in PDQ-39 scores (r = 0.538, p < 0.001), and between the rate of improvement in HAM-D scores and the rate of improvement in PDQ-39 scores (r = 0.404, p = 0.002) at the 6-month follow-up. HAM-A and HAM-D scores were positively correlated with the Parkinson’s Hoehn-Yahr disease stage (r = 0.296, p = 0.025; and r = 0.380, p = 0.004, respectively).

Conclusion:

Bilateral STN-DBS can improve symptoms of anxiety and depression in PD patients.

Keywords:

Parkinson’s disease, deep brain stimulation, subthalamic nucleus, anxiety, depression, quality of life
Received: 11 November 2021 Revised: 25 January 2022 Accepted: 15 February 2022 Published: 05 March 2022 Issue date: March 2022
References(32)
[1]
Lu JC, Feng ZH, Shi X, et al. Correlation between programmed stimulation parameters and their efficacy after deep brain electrode implantation for Parkinson’s disease. J Neurorestoratol 2020, 8(1): 53-59.
[2]
Wichmann T, DeLong MR. Deep brain stimulation for movement disorders of basal Ganglia origin: restoring function or functionality? Neurotherapeutics 2016, 13(2): 264-283.
[3]
Birchall EL, Walker HC, Cutter G, et al. The effect of unilateral subthalamic nucleus deep brain stimulation on depression in Parkinson’s disease. Brain Stimul 2017, 10(3): 651-656
[4]
Berg D, Lang AE, Postuma RB, et al. Changing the research criteria for the diagnosis of Parkinson’s disease: obstacles and opportunities. Lancet Neurol 2013, 12(5): 514-524.
[5]
Zach H, Walter U, Liepelt-Scarfone I, et al. Diagnostics of clinical and prodromal idiopathic Parkinson’s disease: new criteria. Nervenarzt 2017, 88(4): 356-364.
[6]
Goetz CG, Tilley BC, Shaftman SR, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 2008, 23(15): 2129-2170.
[7]
Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967, 17(5): 427-442.
[8]
Tomlinson CL, Stowe R, Patel S, et al. Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord 2010, 25(15): 2649-2653.
[9]
Zhang F, Wang F, Li WG, et al. Relationship between electrode position of deep brain stimulation and motor symptoms of Parkinson’s disease. BMC Neurol 2021, 21(1): 122.
[10]
Horn A, Reich M, Vorwerk J, et al. Connectivity Predicts deep brain stimulation outcome in Parkinson disease. Ann Neurol 2017, 82(1): 67-78.
[11]
Chen Y, Hao HW, Chen H, et al. The study on a telemedicine interaction mode for Deep Brain Stimulation postoperative follow-up. Annu Int Conf IEEE Eng Med Biol Soc 2015, 2015: 186-189.
[12]
Wakabayashi K, Tanji k, Mori F, et a1. Lewy body in Parkinson’s disease: molecules implicated in the formation and degradation of alpha-synuclein aggregates. Neuropathology 2007, 27(5): 494-506.
[13]
Dickson DW, Fujishiro H, Orr C, et al. Neuropathology of non-motor features of Parkinson disease. Parkinsonism Relat Disord 2009, 15(Suppl 3): S1-S5.
[14]
Sjödahl Hammarlund C, Hagell P, Nilsson MH. Motor and non-motor predictors of illness-related distress in Parkinson’s disease. Parkinsonism Relat Disord 2012, 18(3): 299-302.
[15]
Yin ZX, Lu GH, Luo YY, et al. Effect of general anesthesia on electrophysiology and postoperative effect of deep brain stimulation for subthalamic nucleus in Parkinson’s disease (in Chinese). Chin J Neuromed 2018, 17(7): 685-691.
[16]
Wang XL, Chang CW, Geng N, et al. Long-term effects of bilateral deep brain stimulation of the subthalamic nucleus on depression in patients with Parkinson’s disease. Parkinsonism Relat Disord 2009, 15(8): 587-591.
[17]
Dulski J, Schinwelski M, Konkel A, et al. The impact of subthalamic deep brain stimulation on sleep and other non-motor symptoms in Parkinson’s disease. Parkinsonism Relat Disord 2019, 64: 138-144.
[18]
Birchall EL, Walker HC, Cutter G, et al. The effect of unilateral subthalamic nucleus deep brain stimulation on depression in Parkinson’s disease. Brain Stimul 2017, 10(3): 651-656.
[19]
Jaafari N, Giré P, Houeto JL. Deep brain stimulation, Parkinson’s disease and neuropsychiatric complications. Presse Med 2009, 38(9): 1335-1342.
[20]
Castelli L, Perozzo P, Zibetti M, et al. Chronic deep brain stimulation of the subthalamic nucleus for Parkinson’s disease: effects on cognition, mood, anxiety and personality traits. Eur Neurol 2006, 55(3): 136-144.
[21]
Kurcova S, Bardon J, Vastik M, et al. Bilateral subthalamic deep brain stimulation initial impact on nonmotor and motor symptoms in Parkinson’s disease: an open prospective single institution study. Medicine (Baltimore) 2018, 97(5): e9750.
[22]
Deuschl G, Schade-Brittinger C, Krack P, et al. A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 2006, 355(9): 896-908.
[23]
Blomstedt P, Hariz MI, Lees A, et al. Acute severe depression induced by intraoperative stimulation of the substantia nigra: a case report. Parkinsonism Relat Disord 2008, 14(3): 253-256.
[24]
Soulas T, Gurruchaga JM, Palfi S, et al. Attempted and completed suicides after subthalamic nucleus stimulation for Parkinson’s disease. J Neurol Neurosurg Psychiatry 2008, 79(8): 952-954.
[25]
Gallagher DA, Schrag A. Psychosis, apathy, depression and anxiety in Parkinson’s disease. Neurobiol Dis 2012, 46(3): 581-589.
[26]
Schrag A, Jahanshahi M, Quinn NP. What contributes to depression in Parkinson’s disease? Psychol Med 2001, 31(1): 65-73.
[27]
Bronstein JM, Tagliati M, Alterman RL, et al. Deep brain stimulation for Parkinson disease: an expert consensus and review of key issues. Arch Neurol 2011, 68(2): 165.
[28]
Follett KA, Weaver FM, Stern M, et al. Pallidal versus subthalamic deep-brain stimulation for Parkinson’s disease. N Engl J Med 2010, 362(22): 2077-2091.
[29]
McDonald LM, Page D, Wilkinson L, et al. Deep brain stimulation of the subthalamic nucleus improves sense of well-being in Parkinson’s disease. Mov Disord 2012, 27(3): 372-378.
[30]
Lyons KE, Pahwa R. Long-term benefits in quality of life provided by bilateral subthalamic stimulation in patients with Parkinson disease. J Neurosurg 2005, 103(2): 252-255.
[31]
Daniels C, Krack P, Volkmann J, et al. Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson’s disease predictable? Mov Disord 2011, 26(14): 2516-2521.
[32]
Bronstein JM, Tagliati M, Alterman RL, et al. Deep brain stimulation for Parkinson disease: an expert consensus and review of key issues. Arch Neurol 2011, 68(2): 165.
Publication history
Copyright
Acknowledgements
Rights and permissions

Publication history

Received: 11 November 2021
Revised: 25 January 2022
Accepted: 15 February 2022
Published: 05 March 2022
Issue date: March 2022

Copyright

© The authors 2022.

Acknowledgements

We are grateful to all the patients recruited for this study. We thank the medical ethics committee of the First Hospital of Hebei Medical University and the medical ethics committee of Beijing Tiantan Hospital Affiliated to Capital Medical University for the approval of our study.

Rights and permissions

This article is published with open access at www.sciopen.com/journal/2324-2426, distributed under the terms of Creative Commons Attribution 4.0 International License (CC BY).

Return