A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease
Identifieur interne : 000612 ( PascalFrancis/Corpus ); précédent : 000611; suivant : 000613A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease
Auteurs : Valerie Voon ; Paul Krack ; Anthony E. Lang ; Andres M. Lozano ; Kathy Dujardin ; Michael Schüpbach ; James D'Ambrosia ; Stephane Thobois ; Filippo Tamma ; Jan Herzog ; Johannes D. Speelman ; Johan Samanta ; Cynthia Kubu ; Helene Rossignol ; Yu-Yan Poon ; Jean A. Saint-Cyr ; Claire Ardouin ; Elena MoroSource :
- Brain [ 0006-8950 ] ; 2008.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. As after other life-altering surgeries, suicides have been reported following deep brain stimulation for movement disorders. We sought to determine the suicide rate following subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres.We further sought to determine factors associated with suicide attempts through a nested case-control study. In the survey of suicide rate, 55/75 centres participated. The completed suicide percentage was 0.45% (24/5311) and attempted suicide percentage was 0.90% (48/5311). Observed suicide rates in the first postoperative year (263/100 000/year) (0.26%) were higher than the lowest and the highest expected age-, gender- and country-adjusted World Health Organization suicide rates (Standardized Mortality Ratio for suicide: SMR 12.63-15.64; P < 0.001) and remained elevated at the fourth postoperative year (38/100 000/year) (0.04%) (SMR 1.81-2.31; P < 0.05). The excess number of deaths was 13 for the first postoperative year and one for the fourth postoperative year. In the case-control study of associated factors, 10 centres participated. Twenty-seven attempted suicides and nine completed suicides were compared with 70 controls. Postoperative depression (P < 0.001), being single (P= 0.007) and a previous history of impulse control disorders or compulsive medication use (P= 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (P < 0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (P < 0.001). Postoperative depression remained a significant factor associated with attempted and completed suicides after correction for multiple comparisons using the stringent Bonferroni correction. Mortality in the first year following subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following subthalamic nucleus deep brain stimulation for Parkinson's disease. Postoperative depression should be carefully assessed and treated. A multidisciplinary assessment and follow-up is recommended.
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| NO : | PASCAL 08-0513094 INIST |
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| ET : | A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease |
| AU : | VOON (Valerie); KRACK (Paul); LANG (Anthony E.); LOZANO (Andres M.); DUJARDIN (Kathy); SCHÜPBACH (Michael); D'AMBROSIA (James); THOBOIS (Stephane); TAMMA (Filippo); HERZOG (Jan); SPEELMAN (Johannes D.); SAMANTA (Johan); KUBU (Cynthia); ROSSIGNOL (Helene); POON (Yu-Yan); SAINT-CYR (Jean A.); ARDOUIN (Claire); MORO (Elena) |
| AF : | National Institute of Neurological Disorders and Stroke, National Institutes of Health/Bethesda, MD/Etats-Unis (1 aut., 7 aut.); University of Toronto, UHN/Toronto, ON/Canada (1 aut., 3 aut., 4 aut., 15 aut., 16 aut., 18 aut.); University Joseph Fourier/Grenoble/France (2 aut., 14 aut., 17 aut.); Lille University Hospital/Lille/France (5 aut.); National Institute of Health and Medical Research (INSERM), Hôpital de la Pitié-Salpêtrière/Paris/France (6 aut.); Université Lyon I, Hospital Neurologique Pierre Wertheimer/Lyon/France (8 aut.); Neurological clinic, Ospedale San Paolo/Italie (9 aut.); Christian-Albrechts-Universität Kiel/Kiel/Allemagne (10 aut.); Academic Medical Center of Amsterdam/Amsterdam/Pays-Bas (11 aut.); University of Arizona/Phoenix, AR/Etats-Unis (12 aut.); The Cleveland Clinic Foundation/OH/Etats-Unis (13 aut.) |
| DT : | Publication en série; Niveau analytique |
| SO : | Brain; ISSN 0006-8950; Royaume-Uni; Da. 2008; Vol. 131; No. p. 10; Pp. 2720-2728; Bibl. 3/4 p. |
| LA : | Anglais |
| EA : | Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. As after other life-altering surgeries, suicides have been reported following deep brain stimulation for movement disorders. We sought to determine the suicide rate following subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres.We further sought to determine factors associated with suicide attempts through a nested case-control study. In the survey of suicide rate, 55/75 centres participated. The completed suicide percentage was 0.45% (24/5311) and attempted suicide percentage was 0.90% (48/5311). Observed suicide rates in the first postoperative year (263/100 000/year) (0.26%) were higher than the lowest and the highest expected age-, gender- and country-adjusted World Health Organization suicide rates (Standardized Mortality Ratio for suicide: SMR 12.63-15.64; P < 0.001) and remained elevated at the fourth postoperative year (38/100 000/year) (0.04%) (SMR 1.81-2.31; P < 0.05). The excess number of deaths was 13 for the first postoperative year and one for the fourth postoperative year. In the case-control study of associated factors, 10 centres participated. Twenty-seven attempted suicides and nine completed suicides were compared with 70 controls. Postoperative depression (P < 0.001), being single (P= 0.007) and a previous history of impulse control disorders or compulsive medication use (P= 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (P < 0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (P < 0.001). Postoperative depression remained a significant factor associated with attempted and completed suicides after correction for multiple comparisons using the stringent Bonferroni correction. Mortality in the first year following subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following subthalamic nucleus deep brain stimulation for Parkinson's disease. Postoperative depression should be carefully assessed and treated. A multidisciplinary assessment and follow-up is recommended. |
| CC : | 002B17; 002B17G |
| FD : | Maladie de Parkinson; Etat dépressif; Pathologie du système nerveux; Suicide; Pronostic; Stimulation cérébrale profonde |
| FG : | Pathologie de l'encéphale; Syndrome extrapyramidal; Maladie dégénérative; Pathologie du système nerveux central; Trouble de l'humeur |
| ED : | Parkinson disease; Depression; Nervous system diseases; Suicide; Prognosis; Deep brain stimulation |
| EG : | Cerebral disorder; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease; Mood disorder |
| SD : | Parkinson enfermedad; Estado depresivo; Sistema nervioso patología; Suicidio; Pronóstico |
| LO : | INIST-998.354000184272200160 |
| ID : | 08-0513094 |
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Speelman</name><affiliation><inist:fA14 i1="09"><s1>Academic Medical Center of Amsterdam</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>11 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Samanta, Johan" sort="Samanta, Johan" uniqKey="Samanta J" first="Johan" last="Samanta">Johan Samanta</name><affiliation><inist:fA14 i1="10"><s1>University of Arizona</s1><s2>Phoenix, AR</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kubu, Cynthia" sort="Kubu, Cynthia" uniqKey="Kubu C" first="Cynthia" last="Kubu">Cynthia Kubu</name><affiliation><inist:fA14 i1="11"><s1>The Cleveland Clinic Foundation</s1><s2>OH</s2><s3>USA</s3><sZ>13 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Rossignol, Helene" sort="Rossignol, Helene" uniqKey="Rossignol H" first="Helene" last="Rossignol">Helene Rossignol</name><affiliation><inist:fA14 i1="03"><s1>University Joseph Fourier</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>14 aut.</sZ><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name><affiliation><inist:fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Saint Cyr, Jean A" sort="Saint Cyr, Jean A" uniqKey="Saint Cyr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name><affiliation><inist:fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name><affiliation><inist:fA14 i1="03"><s1>University Joseph Fourier</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>14 aut.</sZ><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation><inist:fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">08-0513094</idno><date when="2008">2008</date><idno type="stanalyst">PASCAL 08-0513094 INIST</idno><idno type="RBID">Pascal:08-0513094</idno><idno type="wicri:Area/PascalFrancis/Corpus">000612</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease</title><author><name sortKey="Voon, Valerie" sort="Voon, Valerie" uniqKey="Voon V" first="Valerie" last="Voon">Valerie Voon</name><affiliation><inist:fA14 i1="01"><s1>National Institute of Neurological Disorders and Stroke, National Institutes of Health</s1><s2>Bethesda, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><affiliation><inist:fA14 i1="03"><s1>University Joseph Fourier</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>14 aut.</sZ><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation><inist:fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><affiliation><inist:fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Dujardin, Kathy" sort="Dujardin, Kathy" uniqKey="Dujardin K" first="Kathy" last="Dujardin">Kathy Dujardin</name><affiliation><inist:fA14 i1="04"><s1>Lille University Hospital</s1><s2>Lille</s2><s3>FRA</s3><sZ>5 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name><affiliation><inist:fA14 i1="05"><s1>National Institute of Health and Medical Research (INSERM), Hôpital de la Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="D Ambrosia, James" sort="D Ambrosia, James" uniqKey="D Ambrosia J" first="James" last="D'Ambrosia">James D'Ambrosia</name><affiliation><inist:fA14 i1="01"><s1>National Institute of Neurological Disorders and Stroke, National Institutes of Health</s1><s2>Bethesda, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stephane" last="Thobois">Stephane Thobois</name><affiliation><inist:fA14 i1="06"><s1>Université Lyon I, Hospital Neurologique Pierre Wertheimer</s1><s2>Lyon</s2><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Tamma, Filippo" sort="Tamma, Filippo" uniqKey="Tamma F" first="Filippo" last="Tamma">Filippo Tamma</name><affiliation><inist:fA14 i1="07"><s1>Neurological clinic, Ospedale San Paolo</s1><s3>ITA</s3><sZ>9 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Herzog, Jan" sort="Herzog, Jan" uniqKey="Herzog J" first="Jan" last="Herzog">Jan Herzog</name><affiliation><inist:fA14 i1="08"><s1>Christian-Albrechts-Universität Kiel</s1><s2>Kiel</s2><s3>DEU</s3><sZ>10 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Speelman, Johannes D" sort="Speelman, Johannes D" uniqKey="Speelman J" first="Johannes D." last="Speelman">Johannes D. Speelman</name><affiliation><inist:fA14 i1="09"><s1>Academic Medical Center of Amsterdam</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>11 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Samanta, Johan" sort="Samanta, Johan" uniqKey="Samanta J" first="Johan" last="Samanta">Johan Samanta</name><affiliation><inist:fA14 i1="10"><s1>University of Arizona</s1><s2>Phoenix, AR</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Kubu, Cynthia" sort="Kubu, Cynthia" uniqKey="Kubu C" first="Cynthia" last="Kubu">Cynthia Kubu</name><affiliation><inist:fA14 i1="11"><s1>The Cleveland Clinic Foundation</s1><s2>OH</s2><s3>USA</s3><sZ>13 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Rossignol, Helene" sort="Rossignol, Helene" uniqKey="Rossignol H" first="Helene" last="Rossignol">Helene Rossignol</name><affiliation><inist:fA14 i1="03"><s1>University Joseph Fourier</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>14 aut.</sZ><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name><affiliation><inist:fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Saint Cyr, Jean A" sort="Saint Cyr, Jean A" uniqKey="Saint Cyr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name><affiliation><inist:fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name><affiliation><inist:fA14 i1="03"><s1>University Joseph Fourier</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>14 aut.</sZ><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation><inist:fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author></analytic><series><title level="j" type="main">Brain</title><title level="j" type="abbreviated">Brain</title><idno type="ISSN">0006-8950</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Brain</title><title level="j" type="abbreviated">Brain</title><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation</term><term>Depression</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Prognosis</term><term>Suicide</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Etat dépressif</term><term>Pathologie du système nerveux</term><term>Suicide</term><term>Pronostic</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. As after other life-altering surgeries, suicides have been reported following deep brain stimulation for movement disorders. We sought to determine the suicide rate following subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres.We further sought to determine factors associated with suicide attempts through a nested case-control study. In the survey of suicide rate, 55/75 centres participated. The completed suicide percentage was 0.45% (24/5311) and attempted suicide percentage was 0.90% (48/5311). Observed suicide rates in the first postoperative year (263/100 000/year) (0.26%) were higher than the lowest and the highest expected age-, gender- and country-adjusted World Health Organization suicide rates (Standardized Mortality Ratio for suicide: SMR 12.63-15.64; P < 0.001) and remained elevated at the fourth postoperative year (38/100 000/year) (0.04%) (SMR 1.81-2.31; P < 0.05). The excess number of deaths was 13 for the first postoperative year and one for the fourth postoperative year. In the case-control study of associated factors, 10 centres participated. Twenty-seven attempted suicides and nine completed suicides were compared with 70 controls. Postoperative depression (P < 0.001), being single (P= 0.007) and a previous history of impulse control disorders or compulsive medication use (P= 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (P < 0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (P < 0.001). Postoperative depression remained a significant factor associated with attempted and completed suicides after correction for multiple comparisons using the stringent Bonferroni correction. Mortality in the first year following subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following subthalamic nucleus deep brain stimulation for Parkinson's disease. Postoperative depression should be carefully assessed and treated. A multidisciplinary assessment and follow-up is recommended.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0006-8950</s0></fA01><fA03 i2="1"><s0>Brain</s0></fA03><fA05><s2>131</s2></fA05><fA06><s3>p. 10</s3></fA06><fA08 i1="01" i2="1" l="ENG"><s1>A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease</s1></fA08><fA11 i1="01" i2="1"><s1>VOON (Valerie)</s1></fA11><fA11 i1="02" i2="1"><s1>KRACK (Paul)</s1></fA11><fA11 i1="03" i2="1"><s1>LANG (Anthony E.)</s1></fA11><fA11 i1="04" i2="1"><s1>LOZANO (Andres M.)</s1></fA11><fA11 i1="05" i2="1"><s1>DUJARDIN (Kathy)</s1></fA11><fA11 i1="06" i2="1"><s1>SCHÜPBACH (Michael)</s1></fA11><fA11 i1="07" i2="1"><s1>D'AMBROSIA (James)</s1></fA11><fA11 i1="08" i2="1"><s1>THOBOIS (Stephane)</s1></fA11><fA11 i1="09" i2="1"><s1>TAMMA (Filippo)</s1></fA11><fA11 i1="10" i2="1"><s1>HERZOG (Jan)</s1></fA11><fA11 i1="11" i2="1"><s1>SPEELMAN (Johannes D.)</s1></fA11><fA11 i1="12" i2="1"><s1>SAMANTA (Johan)</s1></fA11><fA11 i1="13" i2="1"><s1>KUBU (Cynthia)</s1></fA11><fA11 i1="14" i2="1"><s1>ROSSIGNOL (Helene)</s1></fA11><fA11 i1="15" i2="1"><s1>POON (Yu-Yan)</s1></fA11><fA11 i1="16" i2="1"><s1>SAINT-CYR (Jean A.)</s1></fA11><fA11 i1="17" i2="1"><s1>ARDOUIN (Claire)</s1></fA11><fA11 i1="18" i2="1"><s1>MORO (Elena)</s1></fA11><fA14 i1="01"><s1>National Institute of Neurological Disorders and Stroke, National Institutes of Health</s1><s2>Bethesda, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ></fA14><fA14 i1="02"><s1>University of Toronto, UHN</s1><s2>Toronto, ON</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ><sZ>18 aut.</sZ></fA14><fA14 i1="03"><s1>University Joseph Fourier</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>14 aut.</sZ><sZ>17 aut.</sZ></fA14><fA14 i1="04"><s1>Lille University Hospital</s1><s2>Lille</s2><s3>FRA</s3><sZ>5 aut.</sZ></fA14><fA14 i1="05"><s1>National Institute of Health and Medical Research (INSERM), Hôpital de la Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ></fA14><fA14 i1="06"><s1>Université Lyon I, Hospital Neurologique Pierre Wertheimer</s1><s2>Lyon</s2><s3>FRA</s3><sZ>8 aut.</sZ></fA14><fA14 i1="07"><s1>Neurological clinic, Ospedale San Paolo</s1><s3>ITA</s3><sZ>9 aut.</sZ></fA14><fA14 i1="08"><s1>Christian-Albrechts-Universität Kiel</s1><s2>Kiel</s2><s3>DEU</s3><sZ>10 aut.</sZ></fA14><fA14 i1="09"><s1>Academic Medical Center of Amsterdam</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>11 aut.</sZ></fA14><fA14 i1="10"><s1>University of Arizona</s1><s2>Phoenix, AR</s2><s3>USA</s3><sZ>12 aut.</sZ></fA14><fA14 i1="11"><s1>The Cleveland Clinic Foundation</s1><s2>OH</s2><s3>USA</s3><sZ>13 aut.</sZ></fA14><fA20><s1>2720-2728</s1></fA20><fA21><s1>2008</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>998</s2><s5>354000184272200160</s5></fA43><fA44><s0>0000</s0><s1>© 2008 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>3/4 p.</s0></fA45><fA47 i1="01" i2="1"><s0>08-0513094</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Brain</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. As after other life-altering surgeries, suicides have been reported following deep brain stimulation for movement disorders. We sought to determine the suicide rate following subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres.We further sought to determine factors associated with suicide attempts through a nested case-control study. In the survey of suicide rate, 55/75 centres participated. The completed suicide percentage was 0.45% (24/5311) and attempted suicide percentage was 0.90% (48/5311). Observed suicide rates in the first postoperative year (263/100 000/year) (0.26%) were higher than the lowest and the highest expected age-, gender- and country-adjusted World Health Organization suicide rates (Standardized Mortality Ratio for suicide: SMR 12.63-15.64; P < 0.001) and remained elevated at the fourth postoperative year (38/100 000/year) (0.04%) (SMR 1.81-2.31; P < 0.05). The excess number of deaths was 13 for the first postoperative year and one for the fourth postoperative year. In the case-control study of associated factors, 10 centres participated. Twenty-seven attempted suicides and nine completed suicides were compared with 70 controls. Postoperative depression (P < 0.001), being single (P= 0.007) and a previous history of impulse control disorders or compulsive medication use (P= 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (P < 0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (P < 0.001). Postoperative depression remained a significant factor associated with attempted and completed suicides after correction for multiple comparisons using the stringent Bonferroni correction. Mortality in the first year following subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following subthalamic nucleus deep brain stimulation for Parkinson's disease. Postoperative depression should be carefully assessed and treated. A multidisciplinary assessment and follow-up is recommended.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Maladie de Parkinson</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Etat dépressif</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Depression</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Estado depresivo</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Suicide</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Suicide</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Suicidio</s0><s5>09</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Pronostic</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Prognosis</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Pronóstico</s0><s5>10</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Stimulation cérébrale profonde</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Deep brain stimulation</s0><s4>CD</s4><s5>96</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Trouble de l'humeur</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Mood disorder</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Trastorno humor</s0><s5>42</s5></fC07><fN21><s1>336</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard><server><NO>PASCAL 08-0513094 INIST</NO><ET>A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease</ET><AU>VOON (Valerie); KRACK (Paul); LANG (Anthony E.); LOZANO (Andres M.); DUJARDIN (Kathy); SCHÜPBACH (Michael); D'AMBROSIA (James); THOBOIS (Stephane); TAMMA (Filippo); HERZOG (Jan); SPEELMAN (Johannes D.); SAMANTA (Johan); KUBU (Cynthia); ROSSIGNOL (Helene); POON (Yu-Yan); SAINT-CYR (Jean A.); ARDOUIN (Claire); MORO (Elena)</AU><AF>National Institute of Neurological Disorders and Stroke, National Institutes of Health/Bethesda, MD/Etats-Unis (1 aut., 7 aut.); University of Toronto, UHN/Toronto, ON/Canada (1 aut., 3 aut., 4 aut., 15 aut., 16 aut., 18 aut.); University Joseph Fourier/Grenoble/France (2 aut., 14 aut., 17 aut.); Lille University Hospital/Lille/France (5 aut.); National Institute of Health and Medical Research (INSERM), Hôpital de la Pitié-Salpêtrière/Paris/France (6 aut.); Université Lyon I, Hospital Neurologique Pierre Wertheimer/Lyon/France (8 aut.); Neurological clinic, Ospedale San Paolo/Italie (9 aut.); Christian-Albrechts-Universität Kiel/Kiel/Allemagne (10 aut.); Academic Medical Center of Amsterdam/Amsterdam/Pays-Bas (11 aut.); University of Arizona/Phoenix, AR/Etats-Unis (12 aut.); The Cleveland Clinic Foundation/OH/Etats-Unis (13 aut.)</AF><DT>Publication en série; Niveau analytique</DT><SO>Brain; ISSN 0006-8950; Royaume-Uni; Da. 2008; Vol. 131; No. p. 10; Pp. 2720-2728; Bibl. 3/4 p.</SO><LA>Anglais</LA><EA>Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. As after other life-altering surgeries, suicides have been reported following deep brain stimulation for movement disorders. We sought to determine the suicide rate following subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres.We further sought to determine factors associated with suicide attempts through a nested case-control study. In the survey of suicide rate, 55/75 centres participated. The completed suicide percentage was 0.45% (24/5311) and attempted suicide percentage was 0.90% (48/5311). Observed suicide rates in the first postoperative year (263/100 000/year) (0.26%) were higher than the lowest and the highest expected age-, gender- and country-adjusted World Health Organization suicide rates (Standardized Mortality Ratio for suicide: SMR 12.63-15.64; P < 0.001) and remained elevated at the fourth postoperative year (38/100 000/year) (0.04%) (SMR 1.81-2.31; P < 0.05). The excess number of deaths was 13 for the first postoperative year and one for the fourth postoperative year. In the case-control study of associated factors, 10 centres participated. Twenty-seven attempted suicides and nine completed suicides were compared with 70 controls. Postoperative depression (P < 0.001), being single (P= 0.007) and a previous history of impulse control disorders or compulsive medication use (P= 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (P < 0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (P < 0.001). Postoperative depression remained a significant factor associated with attempted and completed suicides after correction for multiple comparisons using the stringent Bonferroni correction. Mortality in the first year following subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following subthalamic nucleus deep brain stimulation for Parkinson's disease. Postoperative depression should be carefully assessed and treated. A multidisciplinary assessment and follow-up is recommended.</EA><CC>002B17; 002B17G</CC><FD>Maladie de Parkinson; Etat dépressif; Pathologie du système nerveux; Suicide; Pronostic; Stimulation cérébrale profonde</FD><FG>Pathologie de l'encéphale; Syndrome extrapyramidal; Maladie dégénérative; Pathologie du système nerveux central; Trouble de l'humeur</FG><ED>Parkinson disease; Depression; Nervous system diseases; Suicide; Prognosis; Deep brain stimulation</ED><EG>Cerebral disorder; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease; Mood disorder</EG><SD>Parkinson enfermedad; Estado depresivo; Sistema nervioso patología; Suicidio; Pronóstico</SD><LO>INIST-998.354000184272200160</LO><ID>08-0513094</ID></server></inist></record>Pour manipuler ce document sous Unix (Dilib)
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