Impulse control behaviours in patients with Parkinson's disease after subthalamic deep brain stimulation: de novo cases and 3-year follow-up

Abstract

ICBs were abolished in patients 3 years after STN DBS and DAA dosages were lowered. New ICBs may occur after implant and are transient in most cases. Compulsive eating may be specifically related to STN stimulation.

Molecular imaging to track Parkinson's disease and atypical parkinsonisms: New imaging frontiers

“…These observations suggest that modulation of STN with DBS, although it improves motor functions, may tend in parallel to favor the appearance of certain impulsive behaviors by acting on mechanisms involved in response initiation and/or selection . However, to date, the impact of DBS (and its interaction with dopamine agonist reduction) on the development of ICD is unclear and still quite controversial, given that studies using different approaches have shown conflicting results …”

In Parkinson’s disease STN stimulation enhances responsiveness of movement initiation speed to high reward value

“…It has been reported that STN stimulation induces or worsens apathy (Gervais-Bernard, et al, 2009;Krack, et al, 2003;Saint-Cyr, Trepanier, Kumar, Lozano, & Lang, 2000), while others found no effect or even improvement of apathy following STN DBS surgery (Castelli, et al, 2007;Czernecki, et al, 2005;Schuepbach, et al, 2013). Similarly, STN DBS has been linked with post-surgical de novo emergence of pathological gambling or shopping, but also with improvement of impulse control disorders (Amami, et al, 2015;Demetriades, Rickards, & Cavanna, 2011;Lim, et al, 2009;Moum, et al, 2012). These side-effects have been partly explained by diffusion of current to associative and limbic subthalamic territories, although there is still a debate concerning the impact of STN DBS per se on motivational processes, as opposed to this effect being the result of drug modifications following surgery (Pagonabarraga, Kulisevsky, Strafella, & Krack, 2015) Together with the motor and associative sections, the STN also has a limbic territory, verified by imaging in humans (Lambert, et al, 2012) and preclinical and clinical studies suggest that the STN is indeed involved in modulating motivational processes.…”

Deep brain stimulation for movement disorders

“…STN DBS increase impulsivity under high conflict conditions and can trigger transient and reversible behavioral disorders (mania, aggressiveness, depression). The reduction of medication is associated with the reduction of ICD [27].…”