Impulsivity in Parkinson’s disease patients treated with subthalamic nucleus deep brain stimulation—An exploratory study

Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a recognized treatment in Parkinson’s disease (PD). Knowledge is still limited regarding the possible impact of STN-DBS on personality traits and the personality characteristics of PD patients who undergo surgery. Methods: To assess personality traits in relation to STN-DBS we did an ancillary protocol as part of a prospective randomized study that compared two surgical strategies. Patients were assessed with the Temperament and Character Inventory (TCI), the Urgency, Premeditation, Perseverance and Sensation Seeking impulse behavior scale, the Eysenck Personality Questionnaire (EPQ) and the Toronto Alexithymia Scale preoperatively and after one year of STN-DBS. EPQ and TCI baseline scores were compared with mean scores of healthy reference populations. Results: After 12-months of STN-DBS, there was a significant decline in Persistence compared to baseline. Preoperatively, the STN-DBS patients had significantly lower Persistence and Self-Transcendence scores, and significantly higher scores on Novelty-Seeking, Self-Directedness, Cooperativeness and on Social Conformity than referenced populations. No difference was found in Neuroticism or Harm-Avoidance scores. The baseline prevalence of alexithymia was low and at 1-year follow-up there was no significant change in alexithymia scores. Conclusions: We found a higher baseline level of impulsivity in PD patients who underwent STN-DBS. After one year of STN-DBS, our results indicated that the treatment may affect the patients’ personality by increasing certain aspects of impulsivity. There was no effect on alexithymia. The preoperative personality profile of PD patients might influence the outcome of STN-DBS