Abstract
Objectives: To evaluate the effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) on alexithymia, a deficit in affective regulation, comparing patients with Parkinson’s disease (PD) submitted to STN-DBS (DBS group) to PD patients not yet treated with STN-DBS (pre-DBS group) and to healthy participants (C group).Methods: We recruited 27 consecutive STN-DBS PD patients, 38 consecutive pre-DBS patients and 27 healthy participants. Patients were assessed for alexithymia (Toronto Alexithymia Scale), depression, [beck depression inventory (BDI)], and cognitive functions (reasoning, memory, attentional, and executive tests).Results: The DBS patients performed worse than the pre-DBS patients in the corsi’s block-tapping test, in the phonemic fluency task and in the Frontal Assessment Battery. Around 30% of DBS (29.6%) and pre-DBS (31.6%) patients resulted alexithymic, compared with 14.8% in the C group. The results pointed out significantly higher alexithymia scores in both the DBS and pre-DBS groups compared with the C group, while no difference emerged between the DBS and pre-DBS groups. Pre-DBS group showed a significantly higher BDI score than the C group, while DBS group did not.Conclusion: Although the results suggest that STN-DBS does not affect alexithymia, both the DBS and pre-DBS patients reported higher prevalence (about 30%) of alexithymia than did healthy subjects (14.8%).
Highlights
To evaluate the effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) on alexithymia, a deficit in affective regulation, comparing patients with Parkinson’s disease (PD) submitted to STN-DBS (DBS group) to PD patients not yet treated with STN-DBS and to healthy participants (C group)
The results pointed out significantly higher alexithymia scores in both the DBS and pre-DBS groups compared with the C group, while no difference emerged between the DBS and pre-DBS groups
PATIENTS Three groups of subjects were involved in the case-control design: 27 consecutive PD patients bilaterally implanted for DBS of STN (DBS group), 38 consecutive PD patients under dopaminergic therapy (PRE-DBS group), and 27 healthy control subjects (C group)
Summary
Parkinson’s disease (PD) is a common progressive, disabling neurodegenerative disorder with onset of motor and non-motor features (Müller, 2012), namely with substantial physical, psychological, and social implication (Worth, 2013).Deep brain stimulation of the subthalamic nucleus (STNDBS) is a clinically established procedure for the treatment of motor symptoms in patients with advanced PD (Witt et al, 2008; Gervais-Bernard et al, 2009; Odekerken et al, 2013). Some studies have concluded that STN-DBS is safe from a cognitive standpoint since it does not lead to general cognitive deterioration (Castelli et al, 2006; Parsons et al, 2006), others have evidenced a negative impact on specific cognitive domains such as memory, attention, verbal learning, fluency tasks, and executive functions (Witt et al, 2008; Castelli et al, 2010) Neuropsychiatric complications such as aggressive and psychotic episodes, apathy, hypomania/mania, depressive episodes, and affect dysregulation can occasionally, and often transitively, occur in the post-operative period (Castelli et al, 2006; Witt et al, 2008, 2012; Strutt et al, 2012). There is no single explanation for these neuropsychiatric complications: they could depend on both the indirect influence of STN stimulation on the limbic system, including the influence of electrode placement (Strutt et al, 2012), and on the post-operative reduction of dopaminergic therapy
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