1. Neurosurgery in Parkinson disease: a distressed mind in a repaired body?
- Author
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Schüpbach M, Gargiulo M, Welter ML, Mallet L, Béhar C, Houeto JL, Maltête D, Mesnage V, and Agid Y
- Subjects
- Cognition Disorders diagnosis, Cognition Disorders psychology, Female, Humans, Incidence, Male, Middle Aged, Neurosurgery statistics & numerical data, Neurosurgical Procedures statistics & numerical data, Parkinson Disease diagnosis, Parkinson Disease psychology, Prognosis, Risk Assessment methods, Risk Factors, Subthalamic Nucleus, Switzerland epidemiology, Treatment Outcome, Cognition Disorders epidemiology, Deep Brain Stimulation statistics & numerical data, Outcome Assessment, Health Care, Parkinson Disease epidemiology, Parkinson Disease therapy, Quality of Life, Social Adjustment
- Abstract
Objective: To prospectively evaluate the impact of subthalamic nucleus (STN) stimulation on social adjustment in patients with Parkinson disease (PD)., Methods: Before and 18 to 24 months after bilateral STN stimulation, the authors assessed 29 patients with PD for motor disability, cognition (Mattis dementia rating scale, frontal score), psychiatric morbidity (Mini-5.0.0, MADRS, BAS), quality of life (PDQ-39), social adjustment (Social Adjustment Scale), and psychological status using unstructured in-depth interviews., Results: Despite marked improvement in parkinsonian motor disability, the absence of significant changes in cognitive status, and improvement of activities of daily living and quality of life by the end of the study, social adjustment did not improve. Several kinds of problems with social adjustment were observed, affecting the patients' perception of themselves and their body, marital situation, and professional life. Marital conflicts occurred in 17/24 couples. Only 9 out of 16 patients who had a professional activity before the operation went back to work after surgery., Conclusion: After STN stimulation, patients experienced difficulties in their relations with themselves, their spouses, their families, and their socio-professional environment. The authors suggest a multidisciplinary psychosocial preparation and follow-up to help patients and their entourage cope with the sudden changes in their existence following successful neurosurgery.
- Published
- 2006
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