scholarly journals Caregiver burden and caregiver appraisal of psychiatric symptoms are not modulated by subthalamic deep brain stimulation for Parkinson’s disease

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Philip E. Mosley ◽  
Michael Breakspear ◽  
Terry Coyne ◽  
Peter Silburn ◽  
David Smith
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Caregiver Burden ◽  
Brain Stimulation ◽  
Psychiatric Symptoms ◽  
Caregiver Appraisal ◽  
Deep Brain

scholarly journals Caregiver Burden and Caregiver Appraisal of Psychiatric Symptoms are not Modulated by Subthalamic Deep Brain Stimulation for Parkinson’s Disease

2017 ◽  
Author(s):  
Philip E Mosley ◽  
Michael Breakspear ◽  
Terry Coyne ◽  
Peter Silburn ◽  
David Smith
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Caregiver Burden ◽  
Brain Stimulation ◽  
Postoperative Period ◽  
Psychiatric Symptoms ◽  
Substantial Contribution ◽  
Baseline Values ◽  
Deep Brain

Subthalamic deep brain stimulation is an advanced therapy that typically improves quality of life for persons with Parkinson’s disease (PD). However, the effect on caregiver burden is unclear. We recruited sixty-four persons with PD and their caregivers from a movement disorders clinic during the assessment of eligibility for subthalamic DBS. We used clinician, patient and caregiver-rated instruments to follow the patient-caregiver dyad from pre- to postoperative status, sampling repeatedly in the postoperative period to ascertain fluctuations in phenotypic variables. We employed multivariate models to identify key drivers of burden. We clustered caregiver-rated variables into ‘high’ and ‘low’ symptom groups and examined whether postoperative cluster assignment could be predicted from baseline values. Psychiatric symptoms in the postoperative period made a substantial contribution to longitudinal caregiver burden. The development of stimulation-dependent mood changes was also associated with increased burden. However, caregiver burden and caregiver-rated psychiatric symptom clusters were temporally stable and thus predicted only by their baseline values. We confirmed this finding using frequentist and Bayesian statistics, concluding that in our sample, subthalamic DBS for PD did not significantly influence caregiver burden or caregiver-rated psychiatric symptoms. Specifically, patient-caregiver dyads with high burden and high levels of psychiatric symptoms at baseline were likely to maintain this profile during follow up. These findings support the importance of assessing caregiver burden prior to functional neurosurgery. Furthermore, they suggest that interventions addressing caregiver burden in this population should target those with greater symptomatology at baseline and may usefully prioritise psychiatric symptoms reported by the caregiver.

A Pilot Trial of Cognitive Behavioral Therapy for Caregivers After Deep Brain Stimulation for Parkinson's Disease

2020 ◽  
pp. 089198872092472
Author(s):  
Philip E. Mosley ◽  
Katherine Robinson ◽  
Nadeeka N. Dissanayaka ◽  
Terry Coyne ◽  
Peter Silburn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Caregiver Burden ◽  
Brain Stimulation ◽  
Behavioral Therapy ◽  
Caregiver Quality ◽  
Deep Brain

Subthalamic deep brain stimulation for Parkinson's disease may not ameliorate burden among caregivers. An 8-session, manualized program of cognitive-behavioral therapy (CBT) was delivered to a pilot sample of 10 caregivers (6 females, mean age: 60, age range: 34-79). Primary outcome measures were caregiver burden (Zarit Burden Interview) and caregiver quality of life (Parkinson’s Disease Questionnaire–Carer). Secondary outcome measures comprised ratings of depression and anxiety in the caregiver, in addition to relationship quality. Caregiver burden ( t = 2.91 P = .017) and caregiver anxiety ( t = 2.82 P = .020) symptoms were significantly reduced at completion of the program, and these benefits were maintained 3 months later. Caregiver quality of life had significantly improved by the end of the intervention ( t = 3.02 P = .015), but this effect was not sustained after 3 months. The longitudinal influence of participation in the program on caregiver burden was confirmed in a linear, mixed-effects model, χ2 (3) = 15.1, P = .0017). The intervention was well received by participants, and qualitative feedback was obtained. These results indicate that caregiver burden is modifiable in this cohort with a short course of CBT, that benefits are maintained after termination of the program, and that psychological treatment is acceptable to participants. Larger, controlled trials are justified.

scholarly journals Programming for Stimulation-Induced Transient Nonmotor Psychiatric Symptoms after Bilateral Subthalamic Nucleus Deep Brain Stimulation for Parkinson’s Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-14
Author(s):  
Xi Wu ◽  
Yiqing Qiu ◽  
Keith Simfukwe ◽  
Jiali Wang ◽  
Jianchun Chen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Psychiatric Symptoms ◽  
Flow Diagram ◽  
Stimulation Parameter ◽  
Stn Dbs ◽  
Deep Brain

Background. Stimulation-induced transient nonmotor psychiatric symptoms (STPSs) are side effects following bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson’s disease (PD) patients. We designed algorithms which (1) determine the electrode contacts that induce STPSs and (2) provide a programming protocol to eliminate STPS and maintain the optimal motor functions. Our objective is to test the effectiveness of these algorithms. Materials and Methods. 454 PD patients who underwent programming sessions after STN-DBS implantations were retrospectively analyzed. Only STPS patients were enrolled. In these patients, the contacts inducing STPS were found and the programming protocol algorithms used. Results. Eleven patients were diagnosed with STPS. Of these patients, two had four episodes of crying, and two had four episodes of mirthful laughter. In one patient, two episodes of abnormal sense of spatial orientation were observed. Hallucination episodes were observed twice in one patient, while five patients recorded eight episodes of hypomania. There were no statistical differences between the UPDRS-III under the final stimulation parameter (without STPS) and previous optimum UPDRS-III under the STPSs (p=1.000). Conclusion. The flow diagram used for determining electrode contacts that induce STPS and the programming protocol employed in the treatment of these symptoms are effective.

Suicide in Parkinson’s Disease: A Systematic Review

2019 ◽  
Vol 18 (6) ◽  
pp. 466-477 ◽  
Author(s):  
Isabella Berardelli ◽  
Daniele Belvisi ◽  
Adele Nardella ◽  
Giulia Falcone ◽  
Dorian A. Lamis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Suicidal Ideation ◽  
Brain Stimulation ◽  
Suicide Risk ◽  
Psychiatric Symptoms ◽  
Search Terms ◽  
Deep Brain

: Psychiatric disorders and suicide have been reported in patients suffering from Parkinson’s disease. The aims of the present paper were to determine whether patients with Parkinson’s disease have an increased rate of suicide and to identify the clinical features possibly associated with suicide risk in Parkinson’s disease. We also reviewed the studies on suicide risk in Parkinson’s disease in patients after deep brain stimulation. We performed a Medline, Excerpta Medica, PsycLit, PsycInfo and Index Medicus search to identify all articles published on this topic from 1970 to 2019. The following search terms were used: suicide OR suicide attempt OR suicidal ideation OR suicide risk AND Parkinson’s disease AND Parkinson’s disease and deep brain stimulation. The studies we identified that assessed the suicide rate associated with Parkinson’s disease yielded contrasting results, although an increase in suicidal ideation did emerge. The studies on the effect of deep brain stimulation on suicide risk in Parkinson’s disease also reported mixed findings. Psychiatric symptoms, including depression, appear to be associated with suicide risk in patients with Parkinson’s disease undergoing medical and after surgical treatment. The studies reviewed suggest that suicidal ideation is increased in Parkinson’s disease. Further longitudinal studies designed to assess suicidality in this condition are still needed.

Psychopharmacology for Patients with Parkinson’s Disease and Deep Brain Stimulation: Lessons Learned in an Academic Center

2019 ◽  
Vol 8 (1) ◽  
pp. 41-54 ◽  
Author(s):  
Andreea L. Seritan ◽  
Peter Ureste ◽  
Tammy Duong ◽  
Jill L. Ostrem
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Advanced Disease ◽  
Psychiatric Symptoms ◽  
Functional Improvement ◽  
Current Evidence ◽  
Psychiatric Comorbidities ◽  
Deep Brain

Background:Deep brain stimulation (DBS) is a modern neuromodulation method used in the treatment of advanced movement disorders such as Parkinson’s disease (PD) and dystonia. Patients with PD may have multiple psychiatric comorbidities, notably anxiety, depression, mania or hypomania, and psychosis. DBS surgery may indirectly alleviate psychiatric symptoms by allowing reduction of dopaminergic medications, or as a result of functional improvement. Patients who are considering DBS for PD often have more advanced disease and may be more vulnerable to perioperative psychiatric decline. Albeit infrequently, increased depression, apathy, irritability, hypomania or mania, and suicidal behavior have been observed after DBS surgery. </P><P> Objective: This review aimed to present current evidence and empirical recommendations for the management of the psychiatric symptoms in patients with PD treated with DBS. </P><P> Method: Relevant literature was reviewed and synthesized, along with recommendations informed by the authors’ clinical experience in a large, academic DBS center.Results:Careful evaluation of DBS candidacy, including assessing the risk for perioperative psychiatric decompensation is advised. Maintaining at least eight weeks of psychiatric stability prior to DBS surgery is strongly recommended. Postoperative management can be challenging due to advanced disease, concurrent psychiatric comorbidities, and possible DBS stimulation-related effects on mood and impulse control. Stimulation-induced elevated mood states (mania, hypomania) have started to be recognized as distinct clinical entities, although not included in the current psychiatric nomenclature.Conclusion:Insufficient evidence-based strategies for managing psychiatric symptoms in PD patients with DBS exist at this time. Further research is necessary to uncover best practices in this complex, expanding field.

scholarly journals Deep brain stimulation for patients with Parkinson's disease: Effect on caregiver burden

2018 ◽  
Vol 33 (3) ◽  
pp. 154-159
Author(s):  
J.A. Crespo-Burillo ◽  
D. Rivero-Celada ◽  
A. Saenz-de Cabezón ◽  
J. Casado-Pellejero ◽  
J. Alberdi-Viñas ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Caregiver Burden ◽  
Brain Stimulation ◽  
Disease Effect ◽  
Deep Brain
Sign in / Sign up

Export Citation Format

Share Document