Beneficial effects of bilateral subthalamic stimulation on alexithymia in Parkinson's disease

Dafsari, Haidar S.; Ray‐Chaudhuri, K.; Mahlstedt, Picabo; Sachse, Lena; Steffen, Julia; Petry‐Schmelzer, Jan Niklas; Dembek, Till A.; Reker, Paul; Barbe, Michael T.; Visser‐Vandewalle, Veerle; Fink, Gereon R.; Timmermann, Lars

doi:10.1111/ene.13773

Cited by 30 publications

(24 citation statements)

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“…In accordance with previous studies, we observed an improvement of global NMS burden in patients who underwent STN‐DBS, IJLI, and APO . Considering the relative changes and effect sizes, IJLI and STN‐DBS seemed to be favorable over APO regarding the improvement of NMSS total score.…”

Section: Discussionsupporting

confidence: 91%

EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease

et al. 2019

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A BS TRACT: Objective: Real-life observational report of clinical efficacy of bilateral subthalamic stimulation (STN-DBS), apomorphine (APO), and intrajejunal levodopa infusion (IJLI) on quality of life, motor, and nonmotor symptoms (NMS) in Parkinson's disease (PD). Methods: In this prospective, multicenter, international, reallife cohort observation study of 173 PD patients undergoing STN-DBS (n = 101), IJLI (n = 33), or APO (n = 39) were followed-up using PDQuestionnaire-8, NMSScale (NMSS), Unified PD Rating Scale (UPDRS)-III, UPDRS-IV, and levodopa equivalent daily dose (LEDD) before and 6 months after intervention. Outcome changes were analyzed with Wilcoxon signed-rank or paired t test when parametric tests were applicable. Multiple comparisons were corrected (multiple treatments/scales). Effect strengths were quantified with relative changes, effect size, and number needed to treat. Analyses were computed before and after propensity score matching, balancing demographic and clinical characteristics. Results: In all groups, PDQuestionnaire-8, UPDRS-IV, and NMSS total scores improved significantly at follow-up. ---Levodopa equivalent daily dose was significantly reduced after STN-DBS. Explorative NMSS domain analyses resulted in distinct profiles: STN-DBS improved urinary/ sexual functions, mood/cognition, sleep/fatigue, and the miscellaneous domain. IJLI improved the 3 latter domains and gastrointestinal symptoms. APO improved mood/ cognition, perceptual problems/hallucinations, attention/ memory, and the miscellaneous domain. Overall, STN-DBS and IJLI seemed favorable for NMSS total score, and APO favorable for neuropsychological/neuropsychiatric NMS and PDQuestionnaire-8 outcome.Conclusions: This is the first comparison of quality of life, nonmotor. and motor outcomes in PD patients undergoing STN-DBS, IJLI, and APO in a real-life cohort. Distinct effect profiles were identified for each treatment option. Our results highlight the importance of holistic nonmotor and motor symptoms assessments to personalize treatment choices.

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Section: Discussionsupporting

confidence: 91%

EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease

et al. 2019

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“…In the last decade, the influence of non-motor symptoms was extensively studied [ 41 ]. However, even during the last few years, several neglected non-motor symptoms have emerged or found new spotlights [ 26 , 40 , 42 ]. Our results support the role of alexithymia as a non-motor symptom contributing to impaired quality of life in PD.…”

Section: Discussionmentioning

confidence: 99%

“…Until recently, no intervention in PwP has been described to decrease alexithymia. Dafsari et al reported minor effects of subthalamic nucleus deep brain stimulation reducing alexithymia of PwP [ 26 ]. However, in healthy subjects, alexithymia has been modifiable by mindfulness interventions [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

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Alexithymia Is Associated with Reduced Quality of Life and Increased Caregiver Burden in Parkinson’s Disease

et al. 2020

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Parkinson’s disease (PD) is the second most frequent neurodegenerative disease of people who are beyond 50 years of age. People with PD (PwP) suffer from a large variety of motor and non-motor symptoms resulting in reduced health-related quality of life (HR-QoL). In the last two decades, alexithymia was identified as an additional non-motor symptom in PD. Alexithymia is defined as a cognitive affective disturbance resulting in difficulty to identify and distinguish feelings from bodily sensations of emotional arousal. In PD, the frequency of patients suffering of alexithymia is increased compared to healthy controls. The aim of the present study was to determine the relationship of alexithymia to HR-QoL of the PwP and caregiver burden of the corresponding caregiver. This cross-sectional questionnaire-based study used disease specific questionnaires for HR-QoL and caregiver burden. In total 119 PwP and their corresponding caregivers were included in the study. HR-QoL of the PwP correlated significantly with alexithymia (p < 0.001), especially the sub-components “identifying feelings” (p < 0.001) and “difficulties describing feelings” (p = 0.001). Caregiver burden also correlated significantly with PwP alexithymia (p < 0.001). However, caregiver burden was associated with sub-components “identifying feelings” (p < 0.008) and “external oriented thinking” (p < 0.004). These data support the importance of alexithymia as a non-motor symptom in PD.

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“…Scale subscales for anxiety and depression (HADS-A and -D) was used to examine specific mood disorders [11,42]. The HADS-A and -D subscale range from 0 (no anxiety/depression) to 21 (maximum anxiety/ depression).…”

Section: (3) Mood Disorder: the Hospital Anxiety And Depressionmentioning

confidence: 99%

Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

et al. 2020

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Background Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and sleep symptoms in Parkinson's disease (PD). However, the long-term effects of STN-DBS on sleep and its relationship with QoL outcome are unclear. Methods In this prospective, observational, multicenter study including 73 PD patients undergoing bilateral STN-DBS, we examined PDSleep Scale (PDSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, -activities of daily living, and -complications (SCOPA-A, -B, -C), and levodopa-equivalent daily dose (LEDD) preoperatively, at 5 and 24 months follow-up. Longitudinal changes were analyzed with Friedman-tests or repeated-measures ANOVA, when parametric tests were applicable, and Bonferroni-correction for multiple comparisons. Post-hoc, visits were compared with Wilcoxon signed-rank/t-tests. The magnitude of clinical responses was investigated using effect size.

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Beneficial effects of bilateral subthalamic stimulation on alexithymia in Parkinson's disease

Abstract: 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.

Cited by 30 publications

References 57 publications

EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease

EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease

Alexithymia Is Associated with Reduced Quality of Life and Increased Caregiver Burden in Parkinson’s Disease

Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

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