Do Mood Symptoms Affect Eligibility for Deep Brain Stimulation Use in PD?

Patients with anxiety or depression who underwent deep brain stimulation surgery to treat symptoms of Parkinson disease had outcomes similar to patients without any mood symptoms, according to a study published online in the journal Parkinsonism & Related Disorders.

“The notion that premorbid mood symptoms could disqualify a candidate for surgery would be a disservice,” researchers wrote, “as this group performs comparably to asymptomatic peers.”

According to researchers, anxiety and depression occur in an estimated 30% to 40% of patients with Parkinson disease. Prior to the study, whether emotional symptoms interfered with deep brain stimulation outcomes was largely unknown.

To gauge the link between emotional well-being and deep brain stimulation outcomes, researchers performed neurological, neuropsychological, and emotional assessments of 49 patients with Parkinson disease before and after deep brain stimulation surgery. Before undergoing the surgery, 21 patients were categorized as anxious, 15 were categorized as both anxious and depressed, and 13 were categorized as emotionally asymptomatic.

Patients in all three groups performed similarly on neuropsychological measures of global cognition, processing speed, language, visuospatial, and memory before undergoing deep brain stimulation, according to the study.

After deep brain stimulation surgery, researchers identified declines on several cognitive measures as well as in anxiety symptoms among all participants, but they observed no group differences in changes on neurocognitive measures, mood, or the Unified Parkinson’s Disease Rating Scale.

“Parkinson’s disease patients with mild-moderate anxiety or comorbid anxiety/depression pre- deep brain stimulation do not show greater cognitive, emotional, and motor changes post-deep brain stimulation compared to emotionally asymptomatic patients,” researchers wrote. “These data emphasize the importance of discussing potential deep brain stimulation outcomes, while keeping in mind that psychiatric comorbidity should not necessarily exclude patients from deep brain stimulation.”

—Jolynn Tumolo

Reference

Sarno M, Gaztanaga W, Banerjee N, et al. Revisiting eligibility for deep brain stimulation: do preoperative mood symptoms predict outcomes in Parkinson's disease patients? 2019 February 16;[Epub ahead of print].