Deep brain stimulation proven to improve anxiety and depression in PD

Patients with Parkinson’s disease (PD) showed significant improvement on measurement scales for depression and anxiety when treated with deep brain stimulation of the subthalamic nucleus.

Deep brain stimulation of the subthalamic nucleus (STN-DBS) was associated with a significant improvement in anxiety and depression symptoms among patients with Parkinson’s disease (PD), according to study results published in Journal of Neurorestoratology🇧🇷

PD is the second most common neurological disorder worldwide, in which patients are challenged by both motor and non-motor symptoms. Previous research indicates that 30% to 40% of patients with PD experience stress-related neuropsychiatric symptoms of anxiety and depression that may be related to changes in brain chemistry caused by the disease itself.

DBS has shown efficacy for motor symptoms in advanced PD, but its effect on anxiety and depression symptoms, which are known to have a substantial impact on quality of life, remains unclear.

“Some studies have shown that DBS can improve symptoms of anxiety and depression in patients with PD, while others have found the opposite,” the study authors said.

They conducted a retrospective study of 57 patients with advanced idiopathic PD (male, n = 34) to assess the effect of STN-DBS on anxiety and depression symptoms. Participants underwent bilateral STN-DBS between March 2018 and December 2018 at Beijing Tiantan Hospital, China, with preoperative assessments and 1, 3, and 6-month follow-ups.

Patient scores on the Unified PD Rating Scale-Part III (UPDRS-Ⅲ), the Hamilton Anxiety Rating Scale (HAM-A; range, 0 [no anxiety] to 56 [maximum anxiety]), the Hamilton Depression Rating Scale (HAM-D; range, 0 [no depression] to 68 [maximum depression]) and the 39-item PD Questionnaire (PDQ-39; range, 0 [no QOL impairment] to 124 [maximum QOL impairment]) were evaluated.

“One month after surgery, we turned on the stimulator and programmed the implantable pulse generator. We tested the contacts on each electrode and selected the best stimulation target (that is, the one with which the patient obtains satisfactory improvement with minimal side effects)”, explain the study authors.

Results showed that rates of improvement in anxiety and depression symptoms increased with each follow-up visit. Mean rates of improvement for HAM-A scores at 1, 3, and 6 months were a median (IQR) 23.5% (34.9%), 33.3% (30.9%) and 41.7% (34.9%), respectively (all P < 0.001), and the rates of improvement of median HAM-D scores at these time points were 20.0% (33.3%), 31.0% (32.7%) and 37.5% (33. 4%), respectively (all, P < 0.001).In addition, positive correlations were observed between rates of improvement in HAM-A and PDQ-39 scores (r = 0.538; P < 0.001) and between rates of improvement in HAM-D and PDQ-39 scores (r = 0.404; P = 0.002) at the 6-month follow-up. HAM-A and HAM-D scores were also positively correlated with the Hoehn-Yahr disease staging scale (HAM-A: r = 0.296; P = 0.025; HAM-D: r = 0.380; P = 0.004).

“Future studies should pay more attention to the assessment of non-motor symptoms of PD, especially symptoms of anxiety and depression,” the researchers concluded.

Reference

Zhang F, Wang F, Li CH, et al. Therapeutic effects of deep brain stimulation of the subthalamic nucleus on anxiety and depression in patients with Parkinson’s disease. J Neurorestoratology🇧🇷 Published online March 5, 2022. doi:10.26599/JNR.2022.9040004

Deep brain stimulation proven to improve anxiety and depression in PD

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