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Beneficial effects of bilateral subthalamic stimulation on alexithymia in Parkinson's disease.
Eur J Neurol. 2019 02; 26(2):222-e17.EJ

Abstract

BACKGROUND AND PURPOSE

Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL) and motor and non-motor symptoms in advanced Parkinson's disease (PD). However, its effect on alexithymia and its relationship to other neuropsychiatric symptoms and QoL in PD is unclear.

METHODS

In this prospective, observational study of 39 patients with PD undergoing STN-DBS, we examined the Parkinson's Disease Questionnaire-8 (PDQ-8), 20-item Toronto Alexithymia Scale (TAS-20), Hospital Anxiety and Depression Scale (HADS), Self-Report Manic Inventory (SRMI), Apathy Evaluation Scale (AES), Unified Parkinson's Disease Rating Scale (UPDRS) activities of daily living, UPDRS motor examination and UPDRS complications (UPDRS-II/-III/-IV) and levodopa-equivalent daily dose (LEDD) pre-operatively and at 5-month follow-up. Outcome changes were tested with Wilcoxon signed-rank or paired t-test when parametric tests were applicable and corrected for multiple comparisons. The relationship between outcome changes was explored with bivariate correlations. Additionally, partial correlations between PDQ-8 and TAS-20 were computed controlling for HADS, SRMI and AES change scores. Predictor analyses for PDQ-8 improvement were calculated for all baseline parameters.

RESULTS

The baseline prevalence of alexithymia was 17.9%. We observed significant beneficial effects of STN-DBS on PDQ-8, TAS-20, HADS, UPDRS-II, -III and -IV scores and significant LEDD reduction. The correlation between TAS-20 and PDQ-8 improvements remained significant after controlling for all other aforementioned outcomes. Predictor analyses for PDQ-8 improvement were significant for PDQ-8 and TAS-20.

CONCLUSIONS

This is the first report of beneficial effects of STN-DBS on alexithymia. Alexithymia was significantly associated with QoL outcome independent of anxiety, depression, mania and apathy. Our study highlights the importance of alexithymia for holistic assessments of DBS outcomes.

Authors+Show Affiliations

Department of Neurology, University Hospital Cologne, Cologne, Germany. National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK.National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK.Department of Neurology, University Hospital Cologne, Cologne, Germany.Department of Neurology, University Hospital Cologne, Cologne, Germany.Department of Neurology, University Hospital Cologne, Cologne, Germany.Department of Neurology, University Hospital Cologne, Cologne, Germany.Department of Neurology, University Hospital Cologne, Cologne, Germany.Department of Neurology, University Hospital Cologne, Cologne, Germany.Department of Neurology, University Hospital Cologne, Cologne, Germany.Department of Stereotaxy and Functional Neurosurgery, University Hospital Cologne, Cologne.Department of Neurology, University Hospital Cologne, Cologne, Germany. Cognitive Neuroscience Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany.Department of Neurology, University Hospital Cologne, Cologne, Germany. Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Germany.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30107062

Citation

Dafsari, H S., et al. "Beneficial Effects of Bilateral Subthalamic Stimulation On Alexithymia in Parkinson's Disease." European Journal of Neurology, vol. 26, no. 2, 2019, pp. 222-e17.
Dafsari HS, Ray-Chaudhuri K, Mahlstedt P, et al. Beneficial effects of bilateral subthalamic stimulation on alexithymia in Parkinson's disease. Eur J Neurol. 2019;26(2):222-e17.
Dafsari, H. S., Ray-Chaudhuri, K., Mahlstedt, P., Sachse, L., Steffen, J. K., Petry-Schmelzer, J. N., Dembek, T. A., Reker, P., Barbe, M. T., Visser-Vandewalle, V., Fink, G. R., & Timmermann, L. (2019). Beneficial effects of bilateral subthalamic stimulation on alexithymia in Parkinson's disease. European Journal of Neurology, 26(2), 222-e17. https://doi.org/10.1111/ene.13773
Dafsari HS, et al. Beneficial Effects of Bilateral Subthalamic Stimulation On Alexithymia in Parkinson's Disease. Eur J Neurol. 2019;26(2):222-e17. PubMed PMID: 30107062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Beneficial effects of bilateral subthalamic stimulation on alexithymia in Parkinson's disease. AU - Dafsari,H S, AU - Ray-Chaudhuri,K, AU - Mahlstedt,P, AU - Sachse,L, AU - Steffen,J K, AU - Petry-Schmelzer,J N, AU - Dembek,T A, AU - Reker,P, AU - Barbe,M T, AU - Visser-Vandewalle,V, AU - Fink,G R, AU - Timmermann,L, Y1 - 2018/09/21/ PY - 2018/05/19/received PY - 2018/08/09/accepted PY - 2018/8/15/pubmed PY - 2019/6/19/medline PY - 2018/8/15/entrez KW - 20-item Toronto Alexithymia Scale KW - apathy KW - deep brain stimulation KW - non-motor symptoms KW - quality of life SP - 222 EP - e17 JF - European journal of neurology JO - Eur J Neurol VL - 26 IS - 2 N2 - BACKGROUND AND PURPOSE: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL) and motor and non-motor symptoms in advanced Parkinson's disease (PD). However, its effect on alexithymia and its relationship to other neuropsychiatric symptoms and QoL in PD is unclear. METHODS: In this prospective, observational study of 39 patients with PD undergoing STN-DBS, we examined the Parkinson's Disease Questionnaire-8 (PDQ-8), 20-item Toronto Alexithymia Scale (TAS-20), Hospital Anxiety and Depression Scale (HADS), Self-Report Manic Inventory (SRMI), Apathy Evaluation Scale (AES), Unified Parkinson's Disease Rating Scale (UPDRS) activities of daily living, UPDRS motor examination and UPDRS complications (UPDRS-II/-III/-IV) and levodopa-equivalent daily dose (LEDD) pre-operatively and at 5-month follow-up. Outcome changes were tested with Wilcoxon signed-rank or paired t-test when parametric tests were applicable and corrected for multiple comparisons. The relationship between outcome changes was explored with bivariate correlations. Additionally, partial correlations between PDQ-8 and TAS-20 were computed controlling for HADS, SRMI and AES change scores. Predictor analyses for PDQ-8 improvement were calculated for all baseline parameters. RESULTS: The baseline prevalence of alexithymia was 17.9%. We observed significant beneficial effects of STN-DBS on PDQ-8, TAS-20, HADS, UPDRS-II, -III and -IV scores and significant LEDD reduction. The correlation between TAS-20 and PDQ-8 improvements remained significant after controlling for all other aforementioned outcomes. Predictor analyses for PDQ-8 improvement were significant for PDQ-8 and TAS-20. CONCLUSIONS: This is the first report of beneficial effects of STN-DBS on alexithymia. Alexithymia was significantly associated with QoL outcome independent of anxiety, depression, mania and apathy. Our study highlights the importance of alexithymia for holistic assessments of DBS outcomes. SN - 1468-1331 UR - https://www.unboundmedicine.com/medline/citation/30107062/Beneficial_effects_of_bilateral_subthalamic_stimulation_on_alexithymia_in_Parkinson's_disease_ L2 - https://doi.org/10.1111/ene.13773 DB - PRIME DP - Unbound Medicine ER -