Suicide ideation and behaviours after STN and GPi DBS surgery for Parkinson’s disease: results from a randomised, controlled trial
Identifieur interne : 000000 ( Main/Exploration ); suivant : 000001Suicide ideation and behaviours after STN and GPi DBS surgery for Parkinson’s disease: results from a randomised, controlled trial
Auteurs : Daniel Weintraub [États-Unis] ; John E. Duda [États-Unis] ; Kimberly Carlson [États-Unis] ; Ping Luo [États-Unis] ; Oren Sagher [États-Unis] ; Matthew Stern [États-Unis] ; Kenneth A. Follett [États-Unis] ; Domenic Reda [États-Unis] ; Frances M. Weaver [États-Unis]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2013-10.
Abstract
Background The risk of suicide behaviours post–deep brain stimulation (DBS) surgery in Parkinson’s disease (PD) remains controversial. We assessed if suicide ideation and behaviours are more common in PD patients (1) randomised to DBS surgery versus best medical therapy (BMT); and (2) randomised to subthalamic nucleus (STN) versus globus pallidus interna (GPi) DBS surgery. Methods In Phase 1 of the Veterans Affairs CSP 468 study, 255 PD patients were randomised to DBS surgery (n=121) or 6 months of BMT (n=134). For Phase 2, a total of 299 patients were randomised to STN (n=147) or GPi (n=152) DBS surgery. Patients were assessed serially with the Unified Parkinson's Disease Rating Scale Part I depression item, which queries for suicide ideation; additionally, both suicide behaviour adverse event data and proxy symptoms of increased suicide risk from the Parkinson's Disease Questionnaire (PDQ-39) and the Short Form Health Survey (SF-36) were collected. Results In Phase 1, no suicide behaviours were reported, and new-onset suicide ideation was rare (1.9% for DBS vs 0.9% for BMT; Fisher's exact p=0.61). Proxy symptoms of relevance to suicide ideation were similar in the two groups. Rates of suicide ideation at 6 months were similar for patients randomised to STN versus GPi DBS (1.5% vs 0.7%; Fisher's exact p=0.61), but several proxy symptoms were worse in the STN group. Conclusions Results from the randomised, controlled phase of a DBS surgery study in PD patients do not support a direct association between DBS surgery and an increased risk for suicide ideation and behaviours.
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DOI: 10.1136/jnnp-2012-304396
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Duda</name></author><author><name sortKey="Carlson, Kimberly" sort="Carlson, Kimberly" uniqKey="Carlson K" first="Kimberly" last="Carlson">Kimberly Carlson</name></author><author><name sortKey="Luo, Ping" sort="Luo, Ping" uniqKey="Luo P" first="Ping" last="Luo">Ping Luo</name></author><author><name sortKey="Sagher, Oren" sort="Sagher, Oren" uniqKey="Sagher O" first="Oren" last="Sagher">Oren Sagher</name></author><author><name sortKey="Stern, Matthew" sort="Stern, Matthew" uniqKey="Stern M" first="Matthew" last="Stern">Matthew Stern</name></author><author><name sortKey="Follett, Kenneth A" sort="Follett, Kenneth A" uniqKey="Follett K" first="Kenneth A" last="Follett">Kenneth A. Follett</name></author><author><name sortKey="Reda, Domenic" sort="Reda, Domenic" uniqKey="Reda D" first="Domenic" last="Reda">Domenic Reda</name></author><author><name sortKey="Weaver, Frances M" sort="Weaver, Frances M" uniqKey="Weaver F" first="Frances M" last="Weaver">Frances M. 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Follett</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Omaha VA Medical Center and Division of Neurosurgery, University of Nebraska Medical Center, Omaha, Nebraska</wicri:regionArea><placeName><region type="state">Nebraska</region></placeName></affiliation></author><author><name sortKey="Reda, Domenic" sort="Reda, Domenic" uniqKey="Reda D" first="Domenic" last="Reda">Domenic Reda</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Veterans Affairs Cooperative Studies Program Coordinating Center, Edward Hines Jr Veterans Affairs Hospital, Hines, Illinois</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Weaver, Frances M" sort="Weaver, Frances M" uniqKey="Weaver F" first="Frances M" last="Weaver">Frances M. Weaver</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Health Services Research Center, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Loyola University Stritch School of Medicine, Chicago, Illinois</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2013-10">2013-10</date><biblScope unit="volume">84</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1113">1113</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">4985FBC823D0321D8E7DB4FCC56C8E92767387BA</idno><idno type="DOI">10.1136/jnnp-2012-304396</idno><idno type="href">jnnp-84-1113.pdf</idno><idno type="ArticleID">jnnp-2012-304396</idno><idno type="PMID">23667214</idno><idno type="local">jnnp;84/10/1113</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background The risk of suicide behaviours post–deep brain stimulation (DBS) surgery in Parkinson’s disease (PD) remains controversial. We assessed if suicide ideation and behaviours are more common in PD patients (1) randomised to DBS surgery versus best medical therapy (BMT); and (2) randomised to subthalamic nucleus (STN) versus globus pallidus interna (GPi) DBS surgery. Methods In Phase 1 of the Veterans Affairs CSP 468 study, 255 PD patients were randomised to DBS surgery (n=121) or 6 months of BMT (n=134). For Phase 2, a total of 299 patients were randomised to STN (n=147) or GPi (n=152) DBS surgery. Patients were assessed serially with the Unified Parkinson's Disease Rating Scale Part I depression item, which queries for suicide ideation; additionally, both suicide behaviour adverse event data and proxy symptoms of increased suicide risk from the Parkinson's Disease Questionnaire (PDQ-39) and the Short Form Health Survey (SF-36) were collected. Results In Phase 1, no suicide behaviours were reported, and new-onset suicide ideation was rare (1.9% for DBS vs 0.9% for BMT; Fisher's exact p=0.61). Proxy symptoms of relevance to suicide ideation were similar in the two groups. Rates of suicide ideation at 6 months were similar for patients randomised to STN versus GPi DBS (1.5% vs 0.7%; Fisher's exact p=0.61), but several proxy symptoms were worse in the STN group. Conclusions Results from the randomised, controlled phase of a DBS surgery study in PD patients do not support a direct association between DBS surgery and an increased risk for suicide ideation and behaviours.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Illinois</li><li>Michigan</li><li>Nebraska</li><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Weintraub, Daniel" sort="Weintraub, Daniel" uniqKey="Weintraub D" first="Daniel" last="Weintraub">Daniel Weintraub</name></region><name sortKey="Carlson, Kimberly" sort="Carlson, Kimberly" uniqKey="Carlson K" first="Kimberly" last="Carlson">Kimberly Carlson</name><name sortKey="Duda, John E" sort="Duda, John E" uniqKey="Duda J" first="John E" last="Duda">John E. Duda</name><name sortKey="Duda, John E" sort="Duda, John E" uniqKey="Duda J" first="John E" last="Duda">John E. Duda</name><name sortKey="Follett, Kenneth A" sort="Follett, Kenneth A" uniqKey="Follett K" first="Kenneth A" last="Follett">Kenneth A. Follett</name><name sortKey="Luo, Ping" sort="Luo, Ping" uniqKey="Luo P" first="Ping" last="Luo">Ping Luo</name><name sortKey="Reda, Domenic" sort="Reda, Domenic" uniqKey="Reda D" first="Domenic" last="Reda">Domenic Reda</name><name sortKey="Sagher, Oren" sort="Sagher, Oren" uniqKey="Sagher O" first="Oren" last="Sagher">Oren Sagher</name><name sortKey="Stern, Matthew" sort="Stern, Matthew" uniqKey="Stern M" first="Matthew" last="Stern">Matthew Stern</name><name sortKey="Stern, Matthew" sort="Stern, Matthew" uniqKey="Stern M" first="Matthew" last="Stern">Matthew Stern</name><name sortKey="Weaver, Frances M" sort="Weaver, Frances M" uniqKey="Weaver F" first="Frances M" last="Weaver">Frances M. Weaver</name><name sortKey="Weaver, Frances M" sort="Weaver, Frances M" uniqKey="Weaver F" first="Frances M" last="Weaver">Frances M. Weaver</name><name sortKey="Weintraub, Daniel" sort="Weintraub, Daniel" uniqKey="Weintraub D" first="Daniel" last="Weintraub">Daniel Weintraub</name><name sortKey="Weintraub, Daniel" sort="Weintraub, Daniel" uniqKey="Weintraub D" first="Daniel" last="Weintraub">Daniel Weintraub</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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