Psychiatric adverse effects of Deep Brain Stimulation (DBS) in patients with Parkinson's disease

Luana Brandão de Sales Reis 1; Emily Calmon Londero; Roberta Veiga Pestana Visco Costa 1; Ana Paula Rodrigues dos Santos 1; Renato Teixeira Conceição Júnior 1; Rafael Abib Fernandes Barros 1; João Guilherme Santos Garrido 1.

1. Medicine students at Bahiana School of Medicine na Public Health, Salvador, Bahia, Brazil.

OBJECTIVE: Describe the psychiatric effects in patients with Parkinson's disease (PD) after undergoing the procedure of deep brain stimulation (DBS).

METHODS: Literature review was made on the PubMed platform, using the descriptors “Parkinson disease”, “deep brain stimulation” and “mental disorders”, as well as their synonyms found on the DeCS platform. A systematic review, randomized study and meta-analysis were included, and those who mention psychiatric illnesses after deep brain stimulation in patients with PD, published between 2006 and 2020, were chosen.

RESULTS: After applying the strategies, eighteen articles were found, five of which remain based on the selection criteria. In literature, patients undergoing DBS had a significant incidence of adverse psychiatric effects. Among the findings, patients who developed depression are more frequent. In a systematic review, it was observed that 8% of patients had depression, half of which had suicide as an outcome. The second most recorded effect in the literature was anxiety. Also, in a systematic review, patients with cognitive changes, personality changes, hypersexuality, apathy, aggressiveness, hallucinations and hypomania were also identified, but in percentages lower than 0.5%.

CONCLUSIONS: Several psychiatric effects associated with DBS were found. These psychiatric effects can be common, especially depression and anxiety, but there is no adequate protocol or assessment to identify such situations. Based on current literature, scientific articles on the subject are old and insufficient, indicating the need for further studies in the area.

KEYWORDS: Psychiatric effects; Deep Brain Stimulation; Parkinson's disease.

ACKNOWLEDGMENTS: None

FUNDING/FINANCIAL SUPPORT: None

DOI: https://doi.org/10.21801/ppcrj.2020.S1.14