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Subjectively perceived personality and mood changes associated with subthalamic stimulation in patients with Parkinson's disease

Published online by Cambridge University Press:  12 May 2014

C. J. Lewis ,
F. Maier ,
N. Horstkötter ,
A. Zywczok ,
K. Witt ,
C. Eggers ,
T. D. Meyer ,
T. A. Dembek ,
M. Maarouf  and
E. Moro
...Show all authors
C. J. Lewis*
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
F. Maier
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
N. Horstkötter
Affiliation:
Research Unit Ethics, Institute for the History of Medicine and Medical Ethics, University of Cologne, Cologne, Germany
A. Zywczok
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
K. Witt
Affiliation:
Research Unit Ethics, Institute for the History of Medicine and Medical Ethics, University of Cologne, Cologne, Germany
C. Eggers
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
T. D. Meyer
Affiliation:
Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
T. A. Dembek
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
M. Maarouf
Affiliation:
Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Cologne, Germany
E. Moro
Affiliation:
Movement Disorders Unit, Department of Psychiatry and Neurology, University Hospital Center (CHU) of Grenoble, Grenoble, France
M. Zurowski
Affiliation:
Department of Psychiatry, University of Toronto, University Health Network, Toronto, Canada
C. Woopen
Affiliation:
Research Unit Ethics, Institute for the History of Medicine and Medical Ethics, University of Cologne, Cologne, Germany
J. Kuhn
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
L. Timmermann*
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
*
*Address for correspondence: C. J. Lewis, Department of Neurology, University Hospital Cologne, Kerpener Str. 62, D-50937 Cologne, Germany. (Email: [email protected]) [C.J.L.] (Email: [email protected]) [L.T.]
*Address for correspondence: C. J. Lewis, Department of Neurology, University Hospital Cologne, Kerpener Str. 62, D-50937 Cologne, Germany. (Email: [email protected]) [C.J.L.] (Email: [email protected]) [L.T.]
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Abstract

Background

Clinical and ethical implications of personality and mood changes in Parkinson's disease (PD) patients treated with subthalamic deep brain stimulation (STN-DBS) are under debate. Although subjectively perceived personality changes are often mentioned by patients and caregivers, few empirical studies concerning these changes exist. Therefore, we analysed subjectively perceived personality and mood changes in STN-DBS PD patients.

Method

In this prospective study of the ELSA-DBS group, 27 PD patients were assessed preoperatively and 1 year after STN-DBS surgery. Two categories, personality and mood changes, were analysed with semi-structured interviews. Patients were grouped into personality change yes/no, as well as positive/negative mood change groups. Caregivers were additionally interviewed about patients’ personality changes. Characteristics of each group were assessed with standard neurological and psychiatric measurements. Predictors for changes were analysed.

Results

Personality changes were perceived by six of 27 (22%) patients and by 10 of 23 caregivers (44%). The preoperative hypomania trait was a significant predictor for personality change perceived by patients. Of 21 patients, 12 (57%) perceived mood as positively changed. Higher apathy and anxiety ratings were found in the negative change group.

Conclusions

Our results show that a high proportion of PD patients and caregivers perceived personality changes under STN-DBS, emphasizing the relevance of this topic. Mood changed in positive and negative directions. Standard measurement scales failed to adequately reflect personality or mood changes subjectively perceived by patients. A more individualized preoperative screening and preparation for patients and caregivers, as well as postoperative support, could therefore be useful.

Keywords

Caregiversdeep brain stimulationmood changesParkinson's diseasepersonality changes
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 1 , January 2015 , pp. 73 - 85
Copyright
Copyright © Cambridge University Press 2014 

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