Highlights
- •The overall PD sample had select diminished cognitive functions following surgery.
- •Presurgical mood was not associated with post-surgical cognition and mood changes.
- •There was a trend towards improved mood following deep brain stimulation surgery.
Abstract
Introduction
Anxiety and depression are common in PD, occurring in an estimated 30%–40% of PD patients.
However, the extent to which these emotional symptoms interfere with Deep Brain Stimulation
(DBS) outcomes is not well established. This study examined the association between
pre-operative emotional well-being and postsurgical cognitive, emotional, and motor
performance in PD.
Methods
Forty-nine PD patients underwent neurological, neuropsychological (global cognition,
processing speed, language, visuospatial, memory), and emotional assessments pre-
and post-DBS. Fifteen patients were administered the UPDRS. Patients were divided
into Anxious (Anx; n = 21), Comorbid Anxious and Depressed (Anx + Dep; n = 15), and
Emotionally Asymptomatic (EA; n = 13) based on BAI and BDI-II cutoffs, and compared
on pre-post changes in neurocognitive, mood, and motor scores using analyses of covariance
(ANCOVA), controlling for education, ethnicity, and disease duration.
Results
Pre-DBS, there were no significant differences between the three groups on any neuropsychological
measure. Overall change from pre-to post-DBS revealed declines on multiple cognitive
measures and lower symptom endorsement on the BAI among all participants. No group
differences were observed on neurocognitive measures, mood, or UPDRS.
Conclusions
PD patients with mild-moderate anxiety or comorbid anxiety/depression pre-DBS do not
show greater cognitive, emotional, and motor changes post-DBS compared to emotionally
asymptomatic patients. These data emphasize the importance of discussing potential
DBS outcomes, while keeping in mind that psychiatric comorbidity should not necessarily
exclude patients from DBS. The notion that premorbid mood symptoms could disqualify
a candidate for surgery would be a disservice, as this group performs comparably to
asymptomatic peers.
Keywords
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Article info
Publication history
Published online: February 16, 2019
Accepted:
February 14,
2019
Received in revised form:
February 13,
2019
Received:
December 11,
2018
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
