Magalhães, Andreia DAmstutz, DeborahPetermann, KatrinDebove, InesSousa, MárioMaradan-Gachet, Marie ELachenmayer, Martin LenardWaskönig, JuliaMurcia-Carretero, SandraDiamantaras, Andreas AntoniosTinkhauser, GerdNowacki, AndreasPollo, ClaudioRodriguez-Blazquez, CarmenMartinez-Martin, PabloKrack, Paul2024-03-182024-03-182024BMJ Neurol Open. 2024 Jan 6;6(1):e000524.http://hdl.handle.net/20.500.12105/18984Background: Subthalamic nucleus deep brain stimulation (STN-DBS) is a well-established treatment for motor complications in Parkinson's disease (PD). However, its effects on neuropsychiatric symptoms remain disputed. The aim of this study was to evaluate the effects of STN-DBS on neuropsychiatric symptoms in PD. Methods: We retrospectively assessed 26 patients with PD who underwent a preoperative levodopa challenge and postoperative levodopa and stimulation challenges 1 year after STN-DBS. Based on the Neuropsychiatric Fluctuations Scale, Neuropsychiatric State Scores and Neuropsychiatric Fluctuation Indices (NFIs) were calculated. Mixed-effects models with random effects for intercept were used to examine the association of Neuropsychiatric State Score and NFI with the different assessment conditions. Results: In acute challenge conditions, there was an estimated increase of 15.9 points in the Neuropsychiatric State Score in stimulation ON conditions (95% CI 11.4 to 20.6, p<0.001) and 7.6 points in medication ON conditions (95% CI 3.3 to 11.9, p<0.001). Neuropsychiatric fluctuations induced by levodopa, quantified with NFI, decreased by 35.54% (95% CI 49.3 to 21.8, p<0.001) 1 year after STN-DBS. Conclusions: Bilateral STN-DBS at therapeutic parameters has acute psychotropic effects similar to levodopa and can modulate and decrease levodopa-induced neuropsychiatric fluctuations.engVoRhttp://creativecommons.org/licenses/by-nc/4.0/Electrical stimulationNeuropsychiatryParkinson's diseaseAtribución-NoComercial 4.0 Internacional3819698261e00052410.1136/bmjno-2023-0005242632-6140BMJ neurology openopen access