Title:Management of Impulse Control Disorders with Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s Disease
Volume: 19
Issue: 8
Author(s): Deborah Amstutz, Steffen Paschen, Martin Lenard Lachenmayer, Marie Elise Maradan-Gachet, Günther Deuschl, Paul Krack and Ines Debove*
Affiliation:
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern,Switzerland
Keywords:
Parkinson's disease, impulse control disorders, deep brain stimulation, subthalamic nucleus stimulation, management,
hyperdopaminergic behaviour.
Abstract: Impulse Control Disorders (ICDs) and related disorders are common side effects of dopaminergic
treatment in Parkinson’s Disease (PD) and are associated with negative effects on mental and
physical health, quality of life and interpersonal relationships. Current management options are limited,
as a reduction of dopaminergic medication often leads to worsening of motor symptoms or dopamine agonist
withdrawal syndrome. The aim of this review was to investigate if ICDs improve, worsen, or remain
stable after Subthalamic Nucleus Deep Brain Stimulation (STN-DBS). We reviewed retrospective,
prospective and randomized-controlled studies published between 2000 and 2019 examining the effect
of STN-DBS on one or more ICDs. The number of participants, time of follow-up, methods used to
measure ICDs, type of ICDs, the incidence of ICDs before STN-DBS, the incidence of improvement
(remission or reduction) of ICDs after STN-DBS, the incidence of de novo ICDs after STN-DBS, stimulation
parameters, lead position, change in motor score and change in medication are reported for each
study. Available studies suggest that ICDs improve after STN-DBS in most patients and that persisting
new-onset ICDs induced by STN-DBS are rare. However, more randomized-controlled studies are needed
to confirm the findings and to further investigate the underlying mechanisms.
