Long-term cognitive follow-up of Parkinson's disease patients with impulse control disorders

BackgroundReports on behavioural outcomes after subthalamic nucleus deep brain stimulation in Parkinson’s disease are controversial and limited to short-term data. Long-term observation in a large cohort allows a better counselling and management.MethodsTo determine whether a long-term treatment with subthalamic stimulation induces or reduces impulse control behaviours, neuropsychiatric fluctuations and apathy, 69 patients treated with subthalamic stimulation are prospectively and retrospectively assessed using Ardouin Scale of Behavior in Parkinson’s Disease before and after 3–10 years of stimulation.ResultsAt a mean follow-up of 6 years, all impulse control disorders and dopaminergic addiction were significantly decreased, apart from eating behaviour and hypersexuality. Neuropsychiatric fluctuations also significantly improved (ON euphoria: 38% of the patients before surgery and 1% after surgery, P<0.01; OFF dysphoria: 39% of the patients before surgery and 10% after surgery, P<0.01). However, apathy increased (25% of the patients after surgery and 3% before, P<0.01). With the retrospective analysis, several transient episodes of depression, apathy, anxiety and impulse control disorders occurred.ConclusionsBilateral subthalamic nucleus stimulation was overall very effective in improving impulse control disorders and neuropsychiatric fluctuations in parkinsonian patients in the long term despite a counteracting frequent apathy. Transient episodes of impulse control disorders still occurred within the follow-up. These findings recommend a close follow-up in parkinsonian patients presenting with neuropsychiatric symptoms before deep brain stimulation surgery.Clinical trial registrationNCT01705418;Post-results.

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Trait Anxiety as a Risk Factor for Impulse Control Disorders in de novo Parkinson’s Disease

Journal of Parkinson s Disease ◽

10.3233/jpd-212959 ◽

2021 ◽

pp. 1-9

Author(s):

Pauline Waskowiak ◽

Vincent Koppelmans ◽

Marit F.L. Ruitenberg

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Risk Factor ◽

Trait Anxiety ◽

Impulse Control ◽

De Novo ◽

Impulse Control Disorders ◽

Motor Symptoms ◽

Depression And Anxiety

Background: In addition to the well-known motor symptoms, patients with Parkinson’s disease (PD) also frequently experience disabling non-motor symptoms including impulse control disorders (ICDs). ICDs are characterized by a loss of voluntary control over impulses, drives, or temptations regarding excessive hedonic behavior. Objective: The present study examined whether depression and anxiety in de novo PD patients predict the prospective development of ICDs. Methods: We selected 330 de novo PD patients from the Parkinson’s Progression Markers Initiative database who were free of ICDs at the start of the study. ICD presence at baseline and follow-up assessments was evaluated via the shortened version of the Questionnaire for Impulsive-Compulsive Disorders (QUIP-S). Baseline depression and anxiety were measured via the Geriatric Depression Scale (GDS-15) and State-Trait-Anxiety Inventory (STAI-Y), respectively. Results: A total of 149 participants (45.2%) developed an ICD at follow-up and average time of ICD onset was 35 months after baseline. Results of a Cox regression analysis showed that STAI-Y scores but not GDS-15 scores significantly predicted ICD presence. Specifically, scores reflecting higher trait anxiety were associated with an increased risk of developing an ICD. This effect was not confounded by age, gender or UPDRS motor score. We also replicated the well-established result that dopamine agonist use is predictive of ICDs. Conclusion: Our findings indicate that higher anxiety levels in de novo PD patients represent a risk factor for ICD development during the course of the disorder. This highlights the need for early and routine based anxiety screening in these patients.

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Trait anxiety as a risk factor for impulse control disorders in de novo Parkinson’s disease

10.31234/osf.io/nqd57 ◽

2021 ◽

Author(s):

Pauline Waskowiak ◽

Vincent Koppelmans ◽

Marit Ruitenberg

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Risk Factor ◽

Trait Anxiety ◽

Impulse Control ◽

De Novo ◽

Impulse Control Disorders ◽

Motor Symptoms ◽

Increased Risk

Background: In addition to the well-known motor symptoms, patients with Parkinson’s disease (PD) also frequently experience disabling non-motor symptoms including impulse control disorders (ICDs). ICDs are character-ized by a loss of voluntary control over impulses, drives, or temptations regarding excessive hedonic behavior. Objective: The present study exam-ined whether depression and anxiety in de novo PD patients predict the prospective development of ICDs. Methods: We selected 334 de novo PD patients from the Parkinson’s Progression Markers Initiative database who were free of ICDs at the start of the study. ICD presence at baseline and follow-up assessments was evaluated via the shortened version of the Questionnaire for Impulsive‐Compulsive Disorders (QUIP-S). Baseline de-pression and anxiety were measured via the Geriatric Depression Scale (GDS-15) and State-Trait-Anxiety Inventory (STAI-Y), respectively. Results: A total of 149 participants (45.2%) developed an ICD at follow-up and av-erage time of ICD onset was 35 months after baseline. Results of a Cox re-gression analysis showed that STAI-Y scores but not GDS-15 scores signifi-cantly predicted ICD presence. Specifically, scores reflecting higher trait anxiety were associated with an increased risk of developing an ICD. This effect was not confounded by age, gender or UPDRS motor score. We also replicated the well-established result that dopamine agonist use is predic-tive of ICDs. Conclusions: Our findings indicate that higher anxiety levels in de novo PD patients represent a risk factor for ICD development during the course of the disorder. This highlights the need for early and routine based anxiety screening in these patients.

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Long-term effects of STN-DBS on patients with Parkinson's disease suffering from impulse control disorders

Journal of the Neurological Sciences ◽

10.1016/j.jns.2015.08.958 ◽

2015 ◽

Vol 357 ◽

pp. e273

Author(s):

K. Kashihara ◽

T. Hamaguchi ◽

T. Agari ◽

Y. Takao

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Impulse Control ◽

Impulse Control Disorders ◽

Long Term Effects ◽

Stn Dbs

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Impulse Control Disorders in Parkinson’s Disease: Pathophysiology, Effect of Genetic Polymorphism and Future Research Directions

Austin Journal of Clinical Neurology ◽

10.26420/austinjclinneurol.2017.1100 ◽

2017 ◽

Vol 4 (1) ◽

Author(s):

Bhattacharjee S

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Genetic Polymorphism ◽

Impulse Control ◽

Impulse Control Disorders ◽

Future Research ◽

Research Directions ◽

Future Research Directions

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Faculty Opinions recommendation of Long-term follow-up of a randomized AAV2-GAD gene therapy trial for Parkinson's disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727492597.793530605 ◽

2017 ◽

Author(s):

Laurent Villard

Keyword(s):

Parkinson’S Disease ◽

Gene Therapy ◽

Parkinson's Disease ◽

Gene Therapy Trial ◽

Long Term Follow Up ◽

Therapy Trial

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Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome

Brain Sciences ◽

10.3390/brainsci11040416 ◽

2021 ◽

Vol 11 (4) ◽

pp. 416

Author(s):

Carla Piano ◽

Francesco Bove ◽

Delia Mulas ◽

Enrico Di Stasio ◽

Alfonso Fasano ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Cortex ◽

Clinical Outcome ◽

Motor Cortex Stimulation ◽

Dopaminergic Therapy

Previous investigations have reported on the motor benefits and safety of chronic extradural motor cortex stimulation (EMCS) for patients with Parkinson’s disease (PD), but studies addressing the long-term clinical outcome are still lacking. In this study, nine consecutive PD patients who underwent EMCS were prospectively recruited, with a mean follow-up time of 5.1 ± 2.5 years. As compared to the preoperatory baseline, the Unified Parkinson’s Disease Rating Scale (UPDRS)-III in the off-medication condition significantly decreased by 13.8% at 12 months, 16.1% at 18 months, 18.4% at 24 months, 21% at 36 months, 15.6% at 60 months, and 8.6% at 72 months. The UPDRS-IV decreased by 30.8% at 12 months, 22.1% at 24 months, 25% at 60 months, and 36.5% at 72 months. Dopaminergic therapy showed a progressive reduction, significant at 60 months (11.8%). Quality of life improved by 18.0% at 12 months, and 22.4% at 60 months. No surgical complication, cognitive or behavioral change occurred. The only adverse event reported was an infection of the implantable pulse generator pocket. Even in the long-term follow-up, EMCS was shown to be a safe and effective treatment option in PD patients, resulting in improvements in motor symptoms and quality of life, and reductions in motor complications and dopaminergic therapy.

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