Deciphering the effects of STN DBS on neuropsychiatric fluctuations in Parkinson's disease

Mari Muldmaa; Emmanuelle Schmitt; Roberto Infante; Andrea Kistner; Valérie Fraix; Anna Castrioto; Sara Meoni; Pierre Pélissier; Bettina Debû; Elena Moro

doi:10.1038/s41531-024-00811-1

Deciphering the effects of STN DBS on neuropsychiatric fluctuations in Parkinson's disease

NPJ Parkinsons Dis. 2024 Oct 26;10(1):205. doi: 10.1038/s41531-024-00811-1.

Authors

Mari Muldmaa^{1

2

3}, Emmanuelle Schmitt¹, Roberto Infante^{1

4}, Andrea Kistner¹, Valérie Fraix¹, Anna Castrioto¹, Sara Meoni¹, Pierre Pélissier¹, Bettina Debû¹, Elena Moro⁵

Affiliations

¹ Grenoble Alpes University, Movement Disorders Unit, CHU of Grenoble, Grenoble Institute of Neuroscience, Grenoble, France.
² Department of Neurology, North Estonia Medical Centre, Tallinn, Estonia.
³ Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia.
⁴ Neurological Institute Foundation Casimiro Mondino, Milan, Italy.
⁵ Grenoble Alpes University, Movement Disorders Unit, CHU of Grenoble, Grenoble Institute of Neuroscience, Grenoble, France. emoro@chu-grenoble.fr.

Abstract

The impact of subthalamic nucleus (STN) deep brain stimulation (DBS) on neuropsychiatric fluctuations in Parkinson´s disease (PD) remains unclear. The Neuropsychiatric Fluctuations Scale (NFS) can help to fill this gap, directly measuring fluctuations between the OFF- and ON-medication conditions. The NFS provides NFS-plus (hyperdopaminergic) and NFS-minus (hypodopaminergic) sub-scores. Based on these, the NFS global scores express the overall magnitude of neuropsychiatric symptoms in both the OFF- and ON-medication states. The total fluctuation score (TFS) represents the difference between ON- vs. OFF-medication NFS global scores, thus assessing fluctuations amplitude. The NFS was used to evaluate changes in neuropsychiatric fluctuations between the OFF- and ON-medication conditions before and 1-year after bilateral STN-DBS in 45 PD patients (32 males; mean age, 61.3 ± 7.2 years; PD duration, 10.2 ± 3.0 years). After surgery, the amplitude of neuropsychiatric fluctuations was significantly reduced (p < 0.001), confirming the efficacy of STN-DBS on these symptoms.