La maladie de Parkinson en France (serveur d'exploration)

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A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease

Identifieur interne : 000919 ( Ncbi/Checkpoint ); précédent : 000918; suivant : 000920

A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease

Auteurs : Valerie Voon [États-Unis, Canada] ; Paul Krack [France] ; Anthony E. Lang [Canada] ; Andres M. Lozano [Canada] ; Kathy Dujardin ; Michael Schüpbach [France] ; James D Mbrosia [États-Unis] ; Stephane Thobois [France] ; Filippo Tamma [Italie] ; Jan Herzog [Allemagne] ; Johannes D. Speelman [Pays-Bas] ; Johan Samanta [États-Unis] ; Cynthia Kubu [États-Unis] ; Helene Rossignol [France] ; Yu-Yan Poon [Canada] ; Jean A. Saint-Cyr [Canada] ; Claire Ardouin [France] ; Elena Moro [Canada]

Source :

RBID : PMC:2724899

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.


Url:
DOI: 10.1093/brain/awn214
PubMed: 18941146
PubMed Central: 2724899


Affiliations:


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Le document en format XML

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<name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name>
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<name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name>
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<name sortKey="Voon, Valerie" sort="Voon, Valerie" uniqKey="Voon V" first="Valerie" last="Voon">Valerie Voon</name>
<affiliation wicri:level="2">
<nlm:aff id="AFF1">National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA,</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD</wicri:regionArea>
<placeName>
<region type="state">Maryland</region>
</placeName>
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<affiliation wicri:level="4">
<nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>University of Toronto, UHN, Toronto, ON</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
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<settlement type="city">Toronto</settlement>
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<name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
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<nlm:aff id="AFF1">University Joseph Fourier, Grenoble,</nlm:aff>
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<settlement type="city">Grenoble</settlement>
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<name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name>
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<name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name>
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<name sortKey="Dujardin, Kathy" sort="Dujardin, Kathy" uniqKey="Dujardin K" first="Kathy" last="Dujardin">Kathy Dujardin</name>
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<name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name>
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<nlm:aff id="AFF1">National Institute of Health and Medical Research (INSERM), Hôpital de la Pitié-Salpêtrière, Paris,</nlm:aff>
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<name sortKey="D Mbrosia, James" sort="D Mbrosia, James" uniqKey="D Mbrosia J" first="James" last="D Mbrosia">James D Mbrosia</name>
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<name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stephane" last="Thobois">Stephane Thobois</name>
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<name sortKey="Tamma, Filippo" sort="Tamma, Filippo" uniqKey="Tamma F" first="Filippo" last="Tamma">Filippo Tamma</name>
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<name sortKey="Herzog, Jan" sort="Herzog, Jan" uniqKey="Herzog J" first="Jan" last="Herzog">Jan Herzog</name>
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<wicri:regionArea>Christian-Albrechts-Universität Kiel, Kiel</wicri:regionArea>
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<name sortKey="Speelman, Johannes D" sort="Speelman, Johannes D" uniqKey="Speelman J" first="Johannes D." last="Speelman">Johannes D. Speelman</name>
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<nlm:aff id="AFF1">Academic Medical Center of Amsterdam, Amsterdam, The Netherlands,</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Academic Medical Center of Amsterdam, Amsterdam</wicri:regionArea>
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<settlement type="city">Amsterdam</settlement>
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<name sortKey="Samanta, Johan" sort="Samanta, Johan" uniqKey="Samanta J" first="Johan" last="Samanta">Johan Samanta</name>
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<nlm:aff wicri:cut=" and" id="AFF1">University of Arizona, Phoenix, AR</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Arkansas</region>
</placeName>
<wicri:cityArea>University of Arizona, Phoenix</wicri:cityArea>
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<name sortKey="Kubu, Cynthia" sort="Kubu, Cynthia" uniqKey="Kubu C" first="Cynthia" last="Kubu">Cynthia Kubu</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>The Cleveland Clinic Foundation, OH</wicri:regionArea>
<placeName>
<region type="state">Ohio</region>
</placeName>
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<name sortKey="Rossignol, Helene" sort="Rossignol, Helene" uniqKey="Rossignol H" first="Helene" last="Rossignol">Helene Rossignol</name>
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<placeName>
<settlement type="city">Grenoble</settlement>
<region type="region" nuts="2">Auvergne-Rhône-Alpes</region>
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<wicri:orgArea>University Joseph Fourier</wicri:orgArea>
</affiliation>
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<name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name>
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<nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>University of Toronto, UHN, Toronto, ON</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName>
<settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</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 wicri:level="4">
<nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>University of Toronto, UHN, Toronto, ON</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName>
<settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name>
<affiliation wicri:level="3">
<nlm:aff id="AFF1">University Joseph Fourier, Grenoble,</nlm:aff>
<country>France</country>
<placeName>
<settlement type="city">Grenoble</settlement>
<region type="region" nuts="2">Auvergne-Rhône-Alpes</region>
<region type="old region" nuts="2">Rhône-Alpes</region>
</placeName>
<wicri:orgArea>University Joseph Fourier</wicri:orgArea>
</affiliation>
</author>
<author>
<name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
<affiliation wicri:level="4">
<nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>University of Toronto, UHN, Toronto, ON</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName>
<settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Brain</title>
<idno type="ISSN">0006-8950</idno>
<idno type="eISSN">1460-2156</idno>
<imprint>
<date when="2008">2008</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>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;
<italic>P</italic>
<bold><</bold>
0.001) and remained elevated at the fourth postoperative year (38/100 000/year) (0.04%) (SMR 1.81–2.31;
<italic>P</italic>
<bold><</bold>
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 (
<italic>P</italic>
<bold><</bold>
0.001), being single (
<italic>P</italic>
= 0.007) and a previous history of impulse control disorders or compulsive medication use (
<italic>P</italic>
= 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (
<italic>P</italic>
<bold><</bold>
0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (
<italic>P</italic>
<bold><</bold>
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.</p>
</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Canada</li>
<li>France</li>
<li>Italie</li>
<li>Pays-Bas</li>
<li>États-Unis</li>
</country>
<region>
<li>Arkansas</li>
<li>Auvergne-Rhône-Alpes</li>
<li>Hollande-Septentrionale</li>
<li>Maryland</li>
<li>Ohio</li>
<li>Ontario</li>
<li>Rhône-Alpes</li>
<li>Schleswig-Holstein</li>
<li>Île-de-France</li>
</region>
<settlement>
<li>Amsterdam</li>
<li>Grenoble</li>
<li>Kiel</li>
<li>Lyon</li>
<li>Paris</li>
<li>Toronto</li>
</settlement>
<orgName>
<li>Université de Toronto</li>
</orgName>
</list>
<tree>
<noCountry>
<name sortKey="Dujardin, Kathy" sort="Dujardin, Kathy" uniqKey="Dujardin K" first="Kathy" last="Dujardin">Kathy Dujardin</name>
</noCountry>
<country name="États-Unis">
<region name="Maryland">
<name sortKey="Voon, Valerie" sort="Voon, Valerie" uniqKey="Voon V" first="Valerie" last="Voon">Valerie Voon</name>
</region>
<name sortKey="D Mbrosia, James" sort="D Mbrosia, James" uniqKey="D Mbrosia J" first="James" last="D Mbrosia">James D Mbrosia</name>
<name sortKey="Kubu, Cynthia" sort="Kubu, Cynthia" uniqKey="Kubu C" first="Cynthia" last="Kubu">Cynthia Kubu</name>
<name sortKey="Samanta, Johan" sort="Samanta, Johan" uniqKey="Samanta J" first="Johan" last="Samanta">Johan Samanta</name>
</country>
<country name="Canada">
<region name="Ontario">
<name sortKey="Voon, Valerie" sort="Voon, Valerie" uniqKey="Voon V" first="Valerie" last="Voon">Valerie Voon</name>
</region>
<name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name>
<name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name>
<name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
<name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name>
<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>
</country>
<country name="France">
<region name="Auvergne-Rhône-Alpes">
<name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
</region>
<name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name>
<name sortKey="Rossignol, Helene" sort="Rossignol, Helene" uniqKey="Rossignol H" first="Helene" last="Rossignol">Helene Rossignol</name>
<name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name>
<name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stephane" last="Thobois">Stephane Thobois</name>
</country>
<country name="Italie">
<noRegion>
<name sortKey="Tamma, Filippo" sort="Tamma, Filippo" uniqKey="Tamma F" first="Filippo" last="Tamma">Filippo Tamma</name>
</noRegion>
</country>
<country name="Allemagne">
<region name="Schleswig-Holstein">
<name sortKey="Herzog, Jan" sort="Herzog, Jan" uniqKey="Herzog J" first="Jan" last="Herzog">Jan Herzog</name>
</region>
</country>
<country name="Pays-Bas">
<region name="Hollande-Septentrionale">
<name sortKey="Speelman, Johannes D" sort="Speelman, Johannes D" uniqKey="Speelman J" first="Johannes D." last="Speelman">Johannes D. Speelman</name>
</region>
</country>
</tree>
</affiliations>
</record>

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