Unilateral anterior capsulotomy combined with deep brain stimulation for Parkinson's disease psychosis and motor dysfunctions

Psychosis is a frequent and debilitating non-motor symptom of Parkinson's disease (PD). This study aimed to evaluate the availability of unilateral anterior capsulotomy combined with subthalamic nucleus deep brain stimulation (STN-DBS) in managing advanced PD patients comorbid with psychosis. F...

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Published in:Progress in neuro-psychopharmacology & biological psychiatry 2024-01, Vol.128, p.110865-110865, Article 110865
Main Authors: Wang, Fang, Dai, Lulin, Pan, Yixin, Huang, Peng, Zhang, Chencheng, Sun, Bomin, Li, Dianyou
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Language:English
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Anterior capsulotomy
Deep brain stimulation
Parkinson's disease
Parkinson's disease psychosis
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Dai, Lulin
Pan, Yixin
Huang, Peng
Zhang, Chencheng
Sun, Bomin
Li, Dianyou
description Psychosis is a frequent and debilitating non-motor symptom of Parkinson's disease (PD). This study aimed to evaluate the availability of unilateral anterior capsulotomy combined with subthalamic nucleus deep brain stimulation (STN-DBS) in managing advanced PD patients comorbid with psychosis. Five advanced PD patients with psychosis who had been treated with unilateral anterior capsulotomy combined with bilateral STN-DBS were assessed. The positive subscore of the Positive and Negative Syndrome Scale (PANSS) and the Unified Parkinson's Disease Rating Scale III (UPDRS-III) were used to assess the efficacy parameter of psychosis and the improved motor symptoms, respectively. The quality of life (QoL) was accessed by an 8-item Parkinson's disease Questionnaire (PDQ-8). Clinical outcome assessments were performed at baseline and follow-ups after one or two years. Significant improvement was observed in PD patients during follow-up after the combined treatment. The positive subscore of PANSS improved by 13.4 (5.7) (mean (SD), p = 0.006). Item P1 (delusions) and Item P3 (hallucinations) of the PANSS improved by 5.0 (0.71) (p 
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This study aimed to evaluate the availability of unilateral anterior capsulotomy combined with subthalamic nucleus deep brain stimulation (STN-DBS) in managing advanced PD patients comorbid with psychosis. Five advanced PD patients with psychosis who had been treated with unilateral anterior capsulotomy combined with bilateral STN-DBS were assessed. The positive subscore of the Positive and Negative Syndrome Scale (PANSS) and the Unified Parkinson's Disease Rating Scale III (UPDRS-III) were used to assess the efficacy parameter of psychosis and the improved motor symptoms, respectively. The quality of life (QoL) was accessed by an 8-item Parkinson's disease Questionnaire (PDQ-8). Clinical outcome assessments were performed at baseline and follow-ups after one or two years. Significant improvement was observed in PD patients during follow-up after the combined treatment. The positive subscore of PANSS improved by 13.4 (5.7) (mean (SD), p = 0.006). Item P1 (delusions) and Item P3 (hallucinations) of the PANSS improved by 5.0 (0.71) (p &lt; 0.0001) and 3.6 (0.89) (p = 0.0008), respectively. Furthermore, the motor symptoms improved by 32.4 (5.7) (UPDRS-III, p = 0.0002), and the QoL improved by 6.4 (3.8) (PDQ-8, p = 0.021). No significant side effects or complications occurred during the study. For advanced PD patients with refractory psychosis, unilateral anterior capsulotomy combined with bilateral STN-DBS improved PD psychosis and motor dysfunction, providing an effective therapeutic option for such patients. •Psychosis is a common feature of Parkinson's disease (PD), especially in advanced PD patients, and some patients develop treatment-refractory psychosis. The anterior capsulotomy is used for numerous refractory psychiatric disorders.•This retrospective study showed that unilateral anterior capsulotomy combined with bilateral deep brain stimulation (DBS) improves psychosis and motor symptoms in advanced PD patients with treatment-refractory psychosis.•Adding unilateral anterior capsulotomy may make comorbidity of psychosis not the contraindication of DBS surgery in advanced PD patients.</description><identifier>ISSN: 0278-5846</identifier><identifier>EISSN: 1878-4216</identifier><identifier>DOI: 10.1016/j.pnpbp.2023.110865</identifier><language>eng</language><publisher>Elsevier Inc</publisher><subject>Anterior capsulotomy ; Deep brain stimulation ; Parkinson's disease ; Parkinson's disease psychosis</subject><ispartof>Progress in neuro-psychopharmacology &amp; biological psychiatry, 2024-01, Vol.128, p.110865-110865, Article 110865</ispartof><rights>2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c286t-2844d70376a4eaed2d31f749af08e27290895416cd093cd9b1711d329a9ea8793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Wang, Fang</creatorcontrib><creatorcontrib>Dai, Lulin</creatorcontrib><creatorcontrib>Pan, Yixin</creatorcontrib><creatorcontrib>Huang, Peng</creatorcontrib><creatorcontrib>Zhang, Chencheng</creatorcontrib><creatorcontrib>Sun, Bomin</creatorcontrib><creatorcontrib>Li, Dianyou</creatorcontrib><title>Unilateral anterior capsulotomy combined with deep brain stimulation for Parkinson's disease psychosis and motor dysfunctions</title><title>Progress in neuro-psychopharmacology &amp; biological psychiatry</title><description>Psychosis is a frequent and debilitating non-motor symptom of Parkinson's disease (PD). This study aimed to evaluate the availability of unilateral anterior capsulotomy combined with subthalamic nucleus deep brain stimulation (STN-DBS) in managing advanced PD patients comorbid with psychosis. Five advanced PD patients with psychosis who had been treated with unilateral anterior capsulotomy combined with bilateral STN-DBS were assessed. The positive subscore of the Positive and Negative Syndrome Scale (PANSS) and the Unified Parkinson's Disease Rating Scale III (UPDRS-III) were used to assess the efficacy parameter of psychosis and the improved motor symptoms, respectively. The quality of life (QoL) was accessed by an 8-item Parkinson's disease Questionnaire (PDQ-8). Clinical outcome assessments were performed at baseline and follow-ups after one or two years. Significant improvement was observed in PD patients during follow-up after the combined treatment. The positive subscore of PANSS improved by 13.4 (5.7) (mean (SD), p = 0.006). Item P1 (delusions) and Item P3 (hallucinations) of the PANSS improved by 5.0 (0.71) (p &lt; 0.0001) and 3.6 (0.89) (p = 0.0008), respectively. Furthermore, the motor symptoms improved by 32.4 (5.7) (UPDRS-III, p = 0.0002), and the QoL improved by 6.4 (3.8) (PDQ-8, p = 0.021). No significant side effects or complications occurred during the study. For advanced PD patients with refractory psychosis, unilateral anterior capsulotomy combined with bilateral STN-DBS improved PD psychosis and motor dysfunction, providing an effective therapeutic option for such patients. •Psychosis is a common feature of Parkinson's disease (PD), especially in advanced PD patients, and some patients develop treatment-refractory psychosis. 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This study aimed to evaluate the availability of unilateral anterior capsulotomy combined with subthalamic nucleus deep brain stimulation (STN-DBS) in managing advanced PD patients comorbid with psychosis. Five advanced PD patients with psychosis who had been treated with unilateral anterior capsulotomy combined with bilateral STN-DBS were assessed. The positive subscore of the Positive and Negative Syndrome Scale (PANSS) and the Unified Parkinson's Disease Rating Scale III (UPDRS-III) were used to assess the efficacy parameter of psychosis and the improved motor symptoms, respectively. The quality of life (QoL) was accessed by an 8-item Parkinson's disease Questionnaire (PDQ-8). Clinical outcome assessments were performed at baseline and follow-ups after one or two years. Significant improvement was observed in PD patients during follow-up after the combined treatment. The positive subscore of PANSS improved by 13.4 (5.7) (mean (SD), p = 0.006). Item P1 (delusions) and Item P3 (hallucinations) of the PANSS improved by 5.0 (0.71) (p &lt; 0.0001) and 3.6 (0.89) (p = 0.0008), respectively. Furthermore, the motor symptoms improved by 32.4 (5.7) (UPDRS-III, p = 0.0002), and the QoL improved by 6.4 (3.8) (PDQ-8, p = 0.021). No significant side effects or complications occurred during the study. For advanced PD patients with refractory psychosis, unilateral anterior capsulotomy combined with bilateral STN-DBS improved PD psychosis and motor dysfunction, providing an effective therapeutic option for such patients. •Psychosis is a common feature of Parkinson's disease (PD), especially in advanced PD patients, and some patients develop treatment-refractory psychosis. The anterior capsulotomy is used for numerous refractory psychiatric disorders.•This retrospective study showed that unilateral anterior capsulotomy combined with bilateral deep brain stimulation (DBS) improves psychosis and motor symptoms in advanced PD patients with treatment-refractory psychosis.•Adding unilateral anterior capsulotomy may make comorbidity of psychosis not the contraindication of DBS surgery in advanced PD patients.</abstract><pub>Elsevier Inc</pub><doi>10.1016/j.pnpbp.2023.110865</doi><tpages>1</tpages></addata></record>
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subjects Anterior capsulotomy
Deep brain stimulation
Parkinson's disease
Parkinson's disease psychosis
title Unilateral anterior capsulotomy combined with deep brain stimulation for Parkinson's disease psychosis and motor dysfunctions
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