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Apathy in patients with Parkinson’s disease following deep brain stimulation of the subthalamic nucleus

Published online by Cambridge University Press:  06 May 2016

Isabel Hindle Fisher ,
Hardev S. Pall ,
Rosalind D. Mitchell ,
Jamilla Kausar  and
Andrea E. Cavanna
Isabel Hindle Fisher
Affiliation:
University of Birmingham Medical School, Birmingham, UK
Hardev S. Pall
Affiliation:
School of Clinical and Experimental Medicine, College of Medicine, University of Birmingham, Birmingham, UK
Rosalind D. Mitchell
Affiliation:
Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, UK
Jamilla Kausar
Affiliation:
Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, UK
Andrea E. Cavanna*
Affiliation:
School of Clinical and Experimental Medicine, College of Medicine, University of Birmingham, Birmingham, UK Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK School of Life and Health Sciences, Aston University, Birmingham, UK
*
*Address for correspondence: Andrea E. Cavanna, MD, PhD, FRCP, Department of Neuropsychiatry, The Barberry National Centre for Mental Health, Birmingham B15 2FG, United Kingdom. (Email: a.e.cavanna@bham.ac.uk)
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Abstract

Objective

Apathy has been reported as a possible adverse effect of deep brain stimulation of the subthalamic nucleus (STN-DBS). We investigated the prevalence and severity of apathy in 22 patients with Parkinson’s disease (PD) who underwent STN-DBS, as well as the effects of apathy on quality of life (QOL).

Methods

All patients were assessed with the Lille Apathy Rating Scale (LARS), the Apathy Scale (AS), and the Parkinson’s Disease Questionnaire and were compared to a control group of 38 patients on pharmacotherapy alone.

Results

There were no significant differences in the prevalence or severity of apathy between patients who had undergone STN-DBS and those on pharmacotherapy alone. Significant correlations were observed between poorer QOL and degree of apathy, as measured by the LARS (p<0.001) and the AS (p=0.021). PD-related disability also correlated with both apathy ratings (p<0.001 and p=0.017, respectively).

Conclusion

Our findings suggest that STN-DBS is not necessarily associated with apathy in the PD population; however, more severe apathy appears to be associated with a higher level of disability due to PD and worse QOL, but no other clinico-demographic characteristics.

Keywords

Apathybehaviordeep brain stimulationParkinson’s diseasequality of lifesubthalamic nucleus
Type
Original Research
Information
CNS Spectrums , Volume 21 , Special Issue 3: Neuropsychiatry , June 2016 , pp. 258 - 264
Copyright
© Cambridge University Press 2016 

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Footnotes

The authors would like to thank all the participants who gave up their time to take part in this study. Gratitude is also expressed to Mrs. Lesley Roberts for support during the development and write-up of this project, and to Mr Sayeed Haque, Mr. Roger Holder, and Mrs. Andrea Roalfe for their help with the statistical analyses.

The abstract of the present article was presented at the XXVII British Neuropsychiatry Association Annual General Meeting, London, February 4–6, 2015.

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