Abstract Details

Title Long-term Outcomes for Mood, Anxiety and Apathy in Dystonia with Bilateral DBS Surgery

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 278

Objective We examined the long-term effects of DBS on mood, anxiety and apathy in patients with dystonia who underwent DBS at our center.

Background Mood, anxiety and apathy are frequent nonmotor symptoms reported by patients with dystonia. While the motor outcomes with deep brain stimulation (DBS) surgery targeted to bilateral globus pallidus internus (GPi) or subthalamic nucleus (STN) are well reported, psychiatric outcomes at long-term follow-up are not known. Nonmotor effects of DBS in dystonia are important as they can impact the quality of life.

Design/Methods In an IRB approved protocol, we extracted longitudinal data collected in patients with dystonia DBS using Unified Dystonia Rating Scale for motor outcomes, Beck Depression Inventory, Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI), and Apathy Scale collected before surgery and at six months, one year, three years, and at last available follow-up after surgery (maximum 12 years).

Results We analyzed data on 69 patients; 66 GPi, 3 STN, 8 with STN as rescue lead in addition to GPi; 32 males; mean age 55±22 years; 43 idiopathic, 13 genetic, 41 generalized dystonia. Compared to baseline, the motor outcomes at the last follow-up improved by 28.4% and the depression scores improved by 14.2% (n=69, p=0.04); however the apathy scores revealed worsening by 23.6% (n=28, p=0.02). Anxiety scores measured with STAI (n=26) at 3 ± 2 years follow-up and BAI (n=22) at 6 ± 5 years follow-up did not reveal a significant change. There was no change in the frequency of suicidal thoughts, and there was no report of suicidal attempts in our cohort.

Conclusions While DBS in dystonia led to a slight improvement in depression at long-term follow-up, it worsened apathy. DBS had no effects on suicidal thoughts and attempts and anxiety levels. These findings are important for long-term patient counseling.

Authors/Disclosures
Emma Leone, MD PRESENTER	Ms. Leone has nothing to disclose.
Varun Jain, MD, MBBS	Dr. Jain has nothing to disclose.
	No disclosure on file
Nivedita Jha, MD, MBBS (Tower Health)	Dr. Jha has nothing to disclose.
	No disclosure on file
	No disclosure on file
Kelly D. Foote, MD	Kelly D. Foote, MD has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axio/Neurocrine Biosciences.
Michael S. Okun, MD, FAAN (University of Florida)	Dr. Okun has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Okun has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Parkinson's Foundation. Dr. Okun has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Okun has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch. The institution of Dr. Okun has received research support from NIH. The institution of Dr. Okun has received research support from Parkinson's Foundation. The institution of Dr. Okun has received research support from Tourette Association of America. The institution of Dr. Okun has received research support from Michael J Fox. Dr. Okun has received publishing royalties from a publication relating to health care.
Aparna Wagle-Shukla, MD, FAAN (UF Fixel)	Dr. Wagle-Shukla has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Encora. Dr. Wagle-Shukla has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Supernus. Dr. Wagle-Shukla has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Tremor research group. The institution of Dr. Wagle-Shukla has received research support from NIH. Dr. Wagle-Shukla has received personal compensation in the range of $500-$4,999 for serving as a reviewer with NIH.

��ɫ��

��ɫ��