TY - JOUR
T1 - Acute changes in mood induced by subthalamic deep brain stimulation in Parkinson disease are modulated by psychiatric diagnosis
AU - Eisenstein, Sarah A.
AU - Dewispelaere, William B.
AU - Campbell, Meghan C.
AU - Lugar, Heather M.
AU - Perlmutter, Joel S.
AU - Black, Kevin J.
AU - Hershey, Tamara
N1 - Funding Information:
The authors would like to thank Deboragh Moore, Colleen Considine, Tasha D. Doty, Mary Creech, Emily C. Bihun, Samantha A. Ranck, Dawn Lintzenich, Johanna Hartlein and Angela Wernle for data collection. The authors also thank the following for support: the National Institutes of Health ( R01NS058797 [TH, SAE], R01NS41509 [JSP], K24MH087913 [KJB], UL1TR000448 [WBD, CTSA]); Brain & Behavior Research Foundation [MCC]; American Parkinson Disease Association (APDA) Greater St. Louis chapter; APDA Advanced Research Center at Washington University; and Barnes Jewish Hospital Foundation . The R01NS058797 supported collection, analysis, and interpretation of data and writing this report. Other funding sources did not have specific roles in study design.
Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Background: Deep brain stimulation of the subthalamic nucleus (STN DBS) reduces Parkinson disease (PD) motor symptoms but has unexplained, variable effects on mood.Objective: The study tested the hypothesis that pre-existing mood and/or anxiety disorders or increased symptom severity negatively affects mood response to STN DBS.Methods: Thirty-eight PD participants with bilateral STN DBS and on PD medications were interviewed with Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID) and completed Beck Depression Inventory (BDI) and Spielberger State Anxiety Inventory (SSAI) self-reports. Subsequently, during OFF and optimal ON (clinical settings) STN DBS conditions and while off PD medications, motor function was assessed with the United Parkinson Disease Rating Scale (UPDRS, part III), and participants rated their mood with Visual Analogue Scales (VAS), and again completed SSAI. VAS mood variables included anxiety, apathy, valence and emotional arousal.Results: STN DBS improved UPDRS scores and mood. Unexpectedly, PD participants diagnosed with current anxiety or mood disorders experienced greater STN DBS-induced improvement in mood than those diagnosed with remitted disorders or who were deemed as having never met threshold criteria for diagnosis. BDI and SSAI scores did not modulate mood response to STN DBS, indicating that clinical categorical diagnosis better differentiates mood response to STN DBS than self-rated symptom severity. SCID diagnosis, BDI and SSAI scores did not modulate motor response to STN DBS.Conclusions: PD participants diagnosed with current mood or anxiety disorders are more sensitive to STN DBS-induced effects on mood, possibly indicating altered basal ganglia circuitry in this group.
AB - Background: Deep brain stimulation of the subthalamic nucleus (STN DBS) reduces Parkinson disease (PD) motor symptoms but has unexplained, variable effects on mood.Objective: The study tested the hypothesis that pre-existing mood and/or anxiety disorders or increased symptom severity negatively affects mood response to STN DBS.Methods: Thirty-eight PD participants with bilateral STN DBS and on PD medications were interviewed with Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID) and completed Beck Depression Inventory (BDI) and Spielberger State Anxiety Inventory (SSAI) self-reports. Subsequently, during OFF and optimal ON (clinical settings) STN DBS conditions and while off PD medications, motor function was assessed with the United Parkinson Disease Rating Scale (UPDRS, part III), and participants rated their mood with Visual Analogue Scales (VAS), and again completed SSAI. VAS mood variables included anxiety, apathy, valence and emotional arousal.Results: STN DBS improved UPDRS scores and mood. Unexpectedly, PD participants diagnosed with current anxiety or mood disorders experienced greater STN DBS-induced improvement in mood than those diagnosed with remitted disorders or who were deemed as having never met threshold criteria for diagnosis. BDI and SSAI scores did not modulate mood response to STN DBS, indicating that clinical categorical diagnosis better differentiates mood response to STN DBS than self-rated symptom severity. SCID diagnosis, BDI and SSAI scores did not modulate motor response to STN DBS.Conclusions: PD participants diagnosed with current mood or anxiety disorders are more sensitive to STN DBS-induced effects on mood, possibly indicating altered basal ganglia circuitry in this group.
KW - Anxiety disorder
KW - Deep brain stimulation
KW - Mood
KW - Mood disorder
KW - Parkinson disease
KW - Subthalamic nucleus
UR - http://www.scopus.com/inward/record.url?scp=84929303020&partnerID=8YFLogxK
U2 - 10.1016/j.brs.2014.06.002
DO - 10.1016/j.brs.2014.06.002
M3 - Article
C2 - 25017671
AN - SCOPUS:84929303020
SN - 1935-861X
VL - 7
SP - 701
EP - 708
JO - Brain Stimulation
JF - Brain Stimulation
IS - 5
ER -