Subthalamic nucleus stimulation does not cause deterioration of preexisting hallucinations in Parkinson's disease patients

Fumiaki Yoshida, Yasushi Miyagi, Junji Kishimoto, Takato Morioka, Nobuya Murakami, Kimiaki Hashiguchi, Kazuhiro Samura, Nobutaka Sakae, Ryo Yamasaki, Minako Kawaguchi, Tomio Sasaki

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Abstract

Background: Among the neuropsychiatric symptoms in Parkinson's disease (PD) patients, hallucination can result from the disease itself or medical treatment. Hallucination associated with subthalamic nucleus stimulation (STN-DBS) has been reported; however, it is still unclear whether PD patients with a history of hallucination are appropriate candidates for STN-DBS or not. Aims: We investigated the effect of STN-DBS on preexisting hallucination associated with advanced PD. Methods: Eighteen STN-DBS patients were investigated retrospectively. The severity of hallucination was assessed by the thought disorder score on the Unified Parkinson's Disease Rating Scale (UPDRS, part 1-item 2) in the patients' interviews; the score 6 months after the initiation of STN-DBS was compared with the highest score throughout the preoperative history and the score 2 weeks before surgery. Results: Hoehn-Yahr stage and motor score (UPDRS part 3) were significantly improved following STN-DBS. Six months after the initiation of STN-DBS, the severity of hallucination, assessed by thought disorder score, did not increase, but rather decreased compared with the preoperative level (p < 0.05 by McNemar's test). The daily levodopa equivalent dose was increased in 2 patients without the development of hallucination. On the other hand, anti-parkinsonian drugs were totally withdrawn in 1 patient, but without improvement of hallucination. Conclusions: Our findings indicate that STN-DBS surgery does not always lead to deterioration of preexisting hallucination in PD. In advanced PD, hallucination involves a multifactorial pathogenesis and a history of hallucination is not a contraindication to STN-DBS surgery.

Original languageEnglish
Pages (from-to)45-49
Number of pages5
JournalStereotactic and Functional Neurosurgery
Volume87
Issue number1
DOIs
Publication statusPublished - Feb 1 2009

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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