A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease
Identifieur interne : 000919 ( Ncbi/Checkpoint ); précédent : 000918; suivant : 000920A 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 :
- Brain [ 0006-8950 ] ; 2008.
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;
Url:
DOI: 10.1093/brain/awn214
PubMed: 18941146
PubMed Central: 2724899
Affiliations:
- Allemagne, Canada, France, Italie, Pays-Bas, États-Unis
- Arkansas, Auvergne-Rhône-Alpes, Hollande-Septentrionale, Maryland, Ohio, Ontario, Rhône-Alpes, Schleswig-Holstein, Île-de-France
- Amsterdam, Grenoble, Kiel, Lyon, Paris, Toronto
- Université de Toronto
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PMC:2724899Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">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 wicri:level="2"><nlm:aff id="AFF1">National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA,</nlm:aff>
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<author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
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<author><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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<author><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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<author><name sortKey="Dujardin, Kathy" sort="Dujardin, Kathy" uniqKey="Dujardin K" first="Kathy" last="Dujardin">Kathy Dujardin</name>
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<author><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name>
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<author><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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<author><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stephane" last="Thobois">Stephane Thobois</name>
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<author><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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<author><name sortKey="Samanta, Johan" sort="Samanta, Johan" uniqKey="Samanta J" first="Johan" last="Samanta">Johan Samanta</name>
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<author><name sortKey="Rossignol, Helene" sort="Rossignol, Helene" uniqKey="Rossignol H" first="Helene" last="Rossignol">Helene Rossignol</name>
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<author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name>
<affiliation wicri:level="4"><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
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<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>
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<author><name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name>
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</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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