Premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with Parkinson's disease
BackgroundReduction of medication in Parkinson's disease (PD) following subthalamic nucleus deep brain stimulation (STN-DBS) has been recognized, but the optimal timing for medication adjustments remains unclear, posing challenges in postoperative patient management.ObjectiveThis study aimed to...
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1270746/full |
| _version_ | 1797656022351872000 |
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| author | Yu Diao Tianqi Hu Hutao Xie Houyou Fan Fangang Meng Fangang Meng Anchao Yang Anchao Yang Yutong Bai Jianguo Zhang Jianguo Zhang |
| author_facet | Yu Diao Tianqi Hu Hutao Xie Houyou Fan Fangang Meng Fangang Meng Anchao Yang Anchao Yang Yutong Bai Jianguo Zhang Jianguo Zhang |
| author_sort | Yu Diao |
| collection | DOAJ |
| description | BackgroundReduction of medication in Parkinson's disease (PD) following subthalamic nucleus deep brain stimulation (STN-DBS) has been recognized, but the optimal timing for medication adjustments remains unclear, posing challenges in postoperative patient management.ObjectiveThis study aimed to provide evidence for the timing of medication reduction post-DBS using propensity score matching (PSM).MethodsIn this study, initial programming and observation sessions were conducted over 1 week for patients 4–6 weeks postoperatively. Patients were subsequently categorized into medication reduction or non-reduction groups based on their dyskinesia evaluation using the 4.2-item score from the MDS-UPDRS-IV. PSM was employed to maintain baseline comparability. Short-term motor and neuropsychiatric symptom assessments for both groups were conducted 3–6 months postoperatively.ResultsA total of 123 PD patients were included. Baseline balance in motor and non-motor scores was achieved between the two groups based on PSM. Short-term efficacy revealed a significant reduction in depression scores within the non-reduction group compared to baseline (P < 0.001) and a significant reduction compared to the reduction group (P = 0.037). No significant differences were observed in UPDRS-III and HAMA scores between the two groups. Within-group analysis showed improvements in motor symptoms, depression, anxiety, and subdomains in the non-reduction group, while the reduction group exhibited improvements only in motor symptoms.ConclusionThis study provides evidence for the timing of medication reduction following DBS. Our findings suggest that early maintenance of medication stability is more favorable for improving neuropsychiatric symptoms. |
| first_indexed | 2024-03-11T17:24:22Z |
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| id | doaj.art-02de61084f654fd4a4d84b67e2887d15 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-11T17:24:22Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-02de61084f654fd4a4d84b67e2887d152023-10-19T07:00:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-10-011410.3389/fneur.2023.12707461270746Premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with Parkinson's diseaseYu Diao0Tianqi Hu1Hutao Xie2Houyou Fan3Fangang Meng4Fangang Meng5Anchao Yang6Anchao Yang7Yutong Bai8Jianguo Zhang9Jianguo Zhang10Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, ChinaBackgroundReduction of medication in Parkinson's disease (PD) following subthalamic nucleus deep brain stimulation (STN-DBS) has been recognized, but the optimal timing for medication adjustments remains unclear, posing challenges in postoperative patient management.ObjectiveThis study aimed to provide evidence for the timing of medication reduction post-DBS using propensity score matching (PSM).MethodsIn this study, initial programming and observation sessions were conducted over 1 week for patients 4–6 weeks postoperatively. Patients were subsequently categorized into medication reduction or non-reduction groups based on their dyskinesia evaluation using the 4.2-item score from the MDS-UPDRS-IV. PSM was employed to maintain baseline comparability. Short-term motor and neuropsychiatric symptom assessments for both groups were conducted 3–6 months postoperatively.ResultsA total of 123 PD patients were included. Baseline balance in motor and non-motor scores was achieved between the two groups based on PSM. Short-term efficacy revealed a significant reduction in depression scores within the non-reduction group compared to baseline (P < 0.001) and a significant reduction compared to the reduction group (P = 0.037). No significant differences were observed in UPDRS-III and HAMA scores between the two groups. Within-group analysis showed improvements in motor symptoms, depression, anxiety, and subdomains in the non-reduction group, while the reduction group exhibited improvements only in motor symptoms.ConclusionThis study provides evidence for the timing of medication reduction following DBS. Our findings suggest that early maintenance of medication stability is more favorable for improving neuropsychiatric symptoms.https://www.frontiersin.org/articles/10.3389/fneur.2023.1270746/fullParkinson's diseaseshort-term effectsfollow-updeep brain stimulationpropensity score matchingdepression |
| spellingShingle | Yu Diao Tianqi Hu Hutao Xie Houyou Fan Fangang Meng Fangang Meng Anchao Yang Anchao Yang Yutong Bai Jianguo Zhang Jianguo Zhang Premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with Parkinson's disease Frontiers in Neurology Parkinson's disease short-term effects follow-up deep brain stimulation propensity score matching depression |
| title | Premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with Parkinson's disease |
| title_full | Premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with Parkinson's disease |
| title_fullStr | Premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with Parkinson's disease |
| title_full_unstemmed | Premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with Parkinson's disease |
| title_short | Premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with Parkinson's disease |
| title_sort | premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with parkinson s disease |
| topic | Parkinson's disease short-term effects follow-up deep brain stimulation propensity score matching depression |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1270746/full |
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