Predictors of short-term anxiety outcome in subthalamic stimulation for Parkinson's disease.

Autor: Sauerbier A; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany. anna.sauerbier@uk-koeln.de.; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. anna.sauerbier@uk-koeln.de., Herberg J; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany., Stopic V; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany., Loehrer PA; Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany., Ashkan K; Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK., Rizos A; Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK., Jost ST; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany., Petry-Schmelzer JN; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany., Gronostay A; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany., Schneider C; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany., Visser-Vandewalle V; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne, Germany., Evans J; Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Greater Manchester, UK., Nimsky C; Department of Neurosurgery, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany., Fink GR; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany., Antonini A; Parkinson and Movement Disorders Unit, Department of Neurosciences (DNS), University of Padua, Padova, Italy., Martinez-Martin P; Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain., Silverdale M; Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Greater Manchester, UK., Weintraub D; Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104-2676, USA., Schrag A; Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, University College London, London, UK., Ray Chaudhuri K; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.; Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK., Timmermann L; Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany., Dafsari HS; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany. haidar.dafsari@uk-koeln.de.
Jazyk: angličtina
Zdroj: NPJ Parkinson's disease [NPJ Parkinsons Dis] 2024 Jun 08; Vol. 10 (1), pp. 114. Date of Electronic Publication: 2024 Jun 08.
DOI: 10.1038/s41531-024-00701-6
Abstrakt: The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety in Parkinson's disease (PD) are understudied. We identified clinical predictors of STN-DBS effects on anxiety in this study. In this prospective, open-label, multicentre study, we assessed patients with anxiety undergoing STN-DBS for PD preoperatively and at 6-month follow-up postoperatively. We assessed the Hospital Anxiety and Depression Scale (HADS-anxiety and depression subscales), Unified PD Rating Scale-motor examination, Scales for Outcomes in PD-motor (SCOPA-M)-activities of daily living (ADL) and -motor complications, Non-Motor Symptom Scale (NMSS), PDQuestionnaire-8 (PDQ-8), and levodopa-equivalent daily dose. We tested changes at follow-up with Wilcoxon signed-rank test and corrected for multiple comparisons (Bonferroni method). We identified patients with a clinically relevant anxiety improvement of anxiety based on a designated threshold of ½ standard deviation of baseline HADS-anxiety. Moreover, we investigated predictors of HADS-anxiety changes with correlations and linear regressions. We included 50 patients with clinically relevant baseline anxiety (i.e., HADS-anxiety ≥ 8) aged 63.1 years ± 8.3 with 10.4 years ± 4.5 PD duration. HADS-anxiety improved significantly at 6-month follow-up as 80% of our cohort experienced clinically relevant anxiety improvement. In predictor analyses, worse baseline SCOPA-ADL and NMSS-urinary domain were associated with greater HADS-anxiety improvements. HADS-anxiety and PDQ-8 changes correlated moderately. Worse preoperative ADL and urinary symptoms predicted favourable postoperative anxiety outcome, which in turn was directly proportionate to greater QoL improvement. This study highlights the importance of detailed anxiety assessments alongside other non-motor and motor symptoms when advising and monitoring patients undergoing STN-DBS for PD.
(© 2024. The Author(s).)
Databáze: MEDLINE
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