Abstract
Objectives. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a recognized therapy that improves motor symptoms in advanced Parkinson's disease (PD). However, little is known about its impact on personality. To address this topic, we have assessed personality traits before and after STN-DBS in PD patients. Methods. Forty patients with advanced PD were assessed with the Temperament and Character Inventory (TCI): the Urgency, Premeditation, Perseverance, Sensation Seeking impulsive behaviour scale (UPPS), and the Neuroticism and Lie subscales of the Eysenck Personality Questionnaire (EPQ-N, EPQ-L) before surgery and after three months of STN-DBS. Collateral information obtained from the UPPS was also reported. Results. Despite improvement in motor function and reduction in dopaminergic dosage patients reported lower score on the TCI Persistence and Self-Transcendence scales, after three months of STN-DBS, compared to baseline (P = 0.006; P = 0.024). Relatives reported significantly increased scores on the UPPS Lack of Premeditation scale at follow-up (P = 0.027). Conclusion. STN-DBS in PD patients is associated with personality changes in the direction of increased impulsivity.
Highlights
Parkinson’s disease (PD) is a common neurodegenerative disorder, with a worldwide prevalence of 315 per 100,000 after age 40 [1]
All patients met the diagnostic criteria of the United Kingdom PD Brain Bank [16] and the inclusion criteria of (a) diagnosis of PD for more than five years, (b) Unified Parkinson’s Disease Rating Scale motor subscore (UPDRS-III) >20 points, and (c) severe motor problems that were not controlled by optimized medical treatment
After three months of STN-DBS, we found a significant decline on the Temperament and Character Inventory (TCI) temperament Persistence scale and the character Self-Transcendence scale
Summary
Parkinson’s disease (PD) is a common neurodegenerative disorder, with a worldwide prevalence of 315 per 100,000 after age 40 [1]. PD is a multisystem disease with both motor and nonmotor symptoms. PD is featured by degeneration of the dopaminergic nigrostriatal system and neuronal dysfunction affecting the central, peripheral, and autonomic nervous system [2]. Nonmotor symptoms in PD include cognitive dysfunction and disorders of mood and affect [3]. Patients with PD have been described as compulsive, introverted, and rigid [4]. Personality traits in PD patients may be associated with neuropathological processes that could precede clinical motor dysfunction onset [5] or could be caused by the progressive dopaminergic deficits [6]
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