Predictors of short-term anxiety outcome in subthalamic stimulation for Parkinson’s disease

Anna Sauerbier; Johanna Herberg; Vasilija Stopic; Philipp A. Loehrer; Keyoumars Ashkan; Alexandra Rizos; Stefanie T. Jost; Jan Niklas Petry-Schmelzer; Alexandra Gronostay; Christian Schneider; Veerle Visser-Vandewalle; Julian Evans; Christopher Nimsky; Gereon R. Fink; Angelo Antonini; Pablo Martinez-Martin; Monty Silverdale; Daniel Weintraub; Anette Schrag; K. Ray Chaudhuri; Lars Timmermann; Haidar S. Dafsari; Charles Adler; Roongroj Bhidayasiri; Per Borghammer; Paolo Barone; David J. Brooks; Richard Brown; Marc Cantillon; Camille Carroll; Miguel Coelho; Cristian Falup-Pecurariu; Tove Henriksen; Michele Hu; Peter Jenner; Beomseok Jeon; Milica Kramberger; Padma Kumar; Mónica Kurtis; Valentina Leta; Simon Lewis; Irene Litvan; Kelly Lyons; Davide Martino; Mario Masellis; Hideki Mochizuki; James F. Morley; Melissa Nirenberg; Per Odin; Javier Pagonabarraga; Jalesh Panicker; Nicola Pavese; Eero Pekkonen; Ron Postuma; Mayela Rodriguez Violante; Raymond Rosales; Anthony Schapira; Tanya Simuni; Fabrizio Stocchi; Alexander Storch; Indu Subramanian; Michele Tagliati; Michele Tinazzi; Jon Toledo; Yoshio Tsuboi; Richard Walker

doi:10.1038/s41531-024-00701-6

Predictors of short-term anxiety outcome in subthalamic stimulation for Parkinson’s disease

Anna Sauerbier^*, Johanna Herberg, Vasilija Stopic, Philipp A. Loehrer, Keyoumars Ashkan, Alexandra Rizos, Stefanie T. Jost, Jan Niklas Petry-Schmelzer, Alexandra Gronostay, Christian Schneider, Veerle Visser-Vandewalle, Julian Evans, Christopher Nimsky, Gereon R. Fink, Angelo Antonini, Pablo Martinez-Martin, Monty Silverdale, Daniel Weintraub, Anette Schrag, K. Ray ChaudhuriLars Timmermann, Haidar S. Dafsari^*, Charles Adler, Roongroj Bhidayasiri, Per Borghammer, Paolo Barone, David J. Brooks, Richard Brown, Marc Cantillon, Camille Carroll, Miguel Coelho, Cristian Falup-Pecurariu, Tove Henriksen, Michele Hu, Peter Jenner, Beomseok Jeon, Milica Kramberger, Padma Kumar, Mónica Kurtis, Valentina Leta, Simon Lewis, Irene Litvan, Kelly Lyons, Davide Martino, Mario Masellis, Hideki Mochizuki, James F. Morley, Melissa Nirenberg, Per Odin, Javier Pagonabarraga, Jalesh Panicker, Nicola Pavese, Eero Pekkonen, Ron Postuma, Mayela Rodriguez Violante, Raymond Rosales, Anthony Schapira, Tanya Simuni, Fabrizio Stocchi, Alexander Storch, Indu Subramanian, Michele Tagliati, Michele Tinazzi, Jon Toledo, Yoshio Tsuboi, Richard Walker

^*Corresponding author for this work

Neurology

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety in Parkinson’s disease (PD) are understudied. We identified clinical predictors of STN-DBS effects on anxiety in this study. In this prospective, open-label, multicentre study, we assessed patients with anxiety undergoing STN-DBS for PD preoperatively and at 6-month follow-up postoperatively. We assessed the Hospital Anxiety and Depression Scale (HADS-anxiety and depression subscales), Unified PD Rating Scale-motor examination, Scales for Outcomes in PD-motor (SCOPA-M)-activities of daily living (ADL) and -motor complications, Non-Motor Symptom Scale (NMSS), PDQuestionnaire-8 (PDQ-8), and levodopa-equivalent daily dose. We tested changes at follow-up with Wilcoxon signed-rank test and corrected for multiple comparisons (Bonferroni method). We identified patients with a clinically relevant anxiety improvement of anxiety based on a designated threshold of ½ standard deviation of baseline HADS-anxiety. Moreover, we investigated predictors of HADS-anxiety changes with correlations and linear regressions. We included 50 patients with clinically relevant baseline anxiety (i.e., HADS-anxiety ≥ 8) aged 63.1 years ± 8.3 with 10.4 years ± 4.5 PD duration. HADS-anxiety improved significantly at 6-month follow-up as 80% of our cohort experienced clinically relevant anxiety improvement. In predictor analyses, worse baseline SCOPA-ADL and NMSS-urinary domain were associated with greater HADS-anxiety improvements. HADS-anxiety and PDQ-8 changes correlated moderately. Worse preoperative ADL and urinary symptoms predicted favourable postoperative anxiety outcome, which in turn was directly proportionate to greater QoL improvement. This study highlights the importance of detailed anxiety assessments alongside other non-motor and motor symptoms when advising and monitoring patients undergoing STN-DBS for PD.

Original language	English (US)
Article number	114
Journal	npj Parkinson's Disease
Volume	10
Issue number	1
DOIs	https://doi.org/10.1038/s41531-024-00701-6
State	Published - Dec 2024

Funding

The study center Marburg (PAL, CN, and LT) acknowledges Dr. D.J. Pedrosa for the allocation of patients to different research projects including the present study. This manuscript presents independent research funded by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King\u2019s College London and Parkinson\u2019s UK. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, Parkinson\u2019s UK or the Department of Health. This manuscript presents independent research funded by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King\u2019s College London and Parkinson\u2019s UK. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, Parkinson\u2019s UK or the Department of Health.

ASJC Scopus subject areas

Neurology
Clinical Neurology
Cellular and Molecular Neuroscience

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Cite this

Sauerbier, A., Herberg, J., Stopic, V., Loehrer, P. A., Ashkan, K., Rizos, A., Jost, S. T., Petry-Schmelzer, J. N., Gronostay, A., Schneider, C., Visser-Vandewalle, V., Evans, J., Nimsky, C., Fink, G. R., Antonini, A., Martinez-Martin, P., Silverdale, M., Weintraub, D., Schrag, A., ... Walker, R. (2024). Predictors of short-term anxiety outcome in subthalamic stimulation for Parkinson’s disease. npj Parkinson's Disease, 10(1), Article 114. https://doi.org/10.1038/s41531-024-00701-6

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title = "Predictors of short-term anxiety outcome in subthalamic stimulation for Parkinson{\textquoteright}s disease",

abstract = "The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety in Parkinson{\textquoteright}s disease (PD) are understudied. We identified clinical predictors of STN-DBS effects on anxiety in this study. In this prospective, open-label, multicentre study, we assessed patients with anxiety undergoing STN-DBS for PD preoperatively and at 6-month follow-up postoperatively. We assessed the Hospital Anxiety and Depression Scale (HADS-anxiety and depression subscales), Unified PD Rating Scale-motor examination, Scales for Outcomes in PD-motor (SCOPA-M)-activities of daily living (ADL) and -motor complications, Non-Motor Symptom Scale (NMSS), PDQuestionnaire-8 (PDQ-8), and levodopa-equivalent daily dose. We tested changes at follow-up with Wilcoxon signed-rank test and corrected for multiple comparisons (Bonferroni method). We identified patients with a clinically relevant anxiety improvement of anxiety based on a designated threshold of ½ standard deviation of baseline HADS-anxiety. Moreover, we investigated predictors of HADS-anxiety changes with correlations and linear regressions. We included 50 patients with clinically relevant baseline anxiety (i.e., HADS-anxiety ≥ 8) aged 63.1 years ± 8.3 with 10.4 years ± 4.5 PD duration. HADS-anxiety improved significantly at 6-month follow-up as 80% of our cohort experienced clinically relevant anxiety improvement. In predictor analyses, worse baseline SCOPA-ADL and NMSS-urinary domain were associated with greater HADS-anxiety improvements. HADS-anxiety and PDQ-8 changes correlated moderately. Worse preoperative ADL and urinary symptoms predicted favourable postoperative anxiety outcome, which in turn was directly proportionate to greater QoL improvement. This study highlights the importance of detailed anxiety assessments alongside other non-motor and motor symptoms when advising and monitoring patients undergoing STN-DBS for PD.",

author = "Anna Sauerbier and Johanna Herberg and Vasilija Stopic and Loehrer, {Philipp A.} and Keyoumars Ashkan and Alexandra Rizos and Jost, {Stefanie T.} and Petry-Schmelzer, {Jan Niklas} and Alexandra Gronostay and Christian Schneider and Veerle Visser-Vandewalle and Julian Evans and Christopher Nimsky and Fink, {Gereon R.} and Angelo Antonini and Pablo Martinez-Martin and Monty Silverdale and Daniel Weintraub and Anette Schrag and {Ray Chaudhuri}, K. and Lars Timmermann and Dafsari, {Haidar S.} and Charles Adler and Roongroj Bhidayasiri and Per Borghammer and Paolo Barone and Brooks, {David J.} and Richard Brown and Marc Cantillon and Camille Carroll and Miguel Coelho and Cristian Falup-Pecurariu and Tove Henriksen and Michele Hu and Peter Jenner and Beomseok Jeon and Milica Kramberger and Padma Kumar and M{\'o}nica Kurtis and Valentina Leta and Simon Lewis and Irene Litvan and Kelly Lyons and Davide Martino and Mario Masellis and Hideki Mochizuki and Morley, {James F.} and Melissa Nirenberg and Per Odin and Javier Pagonabarraga and Jalesh Panicker and Nicola Pavese and Eero Pekkonen and Ron Postuma and {Rodriguez Violante}, Mayela and Raymond Rosales and Anthony Schapira and Tanya Simuni and Fabrizio Stocchi and Alexander Storch and Indu Subramanian and Michele Tagliati and Michele Tinazzi and Jon Toledo and Yoshio Tsuboi and Richard Walker",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = dec,

doi = "10.1038/s41531-024-00701-6",

language = "English (US)",

volume = "10",

journal = "npj Parkinson's Disease",

issn = "2373-8057",

publisher = "Springer Nature",

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Sauerbier, A, Herberg, J, Stopic, V, Loehrer, PA, Ashkan, K, Rizos, A, Jost, ST, Petry-Schmelzer, JN, Gronostay, A, Schneider, C, Visser-Vandewalle, V, Evans, J, Nimsky, C, Fink, GR, Antonini, A, Martinez-Martin, P, Silverdale, M, Weintraub, D, Schrag, A, Ray Chaudhuri, K, Timmermann, L, Dafsari, HS, Adler, C, Bhidayasiri, R, Borghammer, P, Barone, P, Brooks, DJ, Brown, R, Cantillon, M, Carroll, C, Coelho, M, Falup-Pecurariu, C, Henriksen, T, Hu, M, Jenner, P, Jeon, B, Kramberger, M, Kumar, P, Kurtis, M, Leta, V, Lewis, S, Litvan, I, Lyons, K, Martino, D, Masellis, M, Mochizuki, H, Morley, JF, Nirenberg, M, Odin, P, Pagonabarraga, J, Panicker, J, Pavese, N, Pekkonen, E, Postuma, R, Rodriguez Violante, M, Rosales, R, Schapira, A, Simuni, T, Stocchi, F, Storch, A, Subramanian, I, Tagliati, M, Tinazzi, M, Toledo, J, Tsuboi, Y & Walker, R 2024, 'Predictors of short-term anxiety outcome in subthalamic stimulation for Parkinson’s disease', npj Parkinson's Disease, vol. 10, no. 1, 114. https://doi.org/10.1038/s41531-024-00701-6

TY - JOUR

T1 - Predictors of short-term anxiety outcome in subthalamic stimulation for Parkinson’s disease

AU - Sauerbier, Anna

AU - Herberg, Johanna

AU - Stopic, Vasilija

AU - Loehrer, Philipp A.

AU - Ashkan, Keyoumars

AU - Rizos, Alexandra

AU - Jost, Stefanie T.

AU - Petry-Schmelzer, Jan Niklas

AU - Gronostay, Alexandra

AU - Schneider, Christian

AU - Visser-Vandewalle, Veerle

AU - Evans, Julian

AU - Nimsky, Christopher

AU - Fink, Gereon R.

AU - Antonini, Angelo

AU - Martinez-Martin, Pablo

AU - Silverdale, Monty

AU - Weintraub, Daniel

AU - Schrag, Anette

AU - Ray Chaudhuri, K.

AU - Timmermann, Lars

AU - Dafsari, Haidar S.

AU - Adler, Charles

AU - Bhidayasiri, Roongroj

AU - Borghammer, Per

AU - Barone, Paolo

AU - Brooks, David J.

AU - Brown, Richard

AU - Cantillon, Marc

AU - Carroll, Camille

AU - Coelho, Miguel

AU - Falup-Pecurariu, Cristian

AU - Henriksen, Tove

AU - Hu, Michele

AU - Jenner, Peter

AU - Jeon, Beomseok

AU - Kramberger, Milica

AU - Kumar, Padma

AU - Kurtis, Mónica

AU - Leta, Valentina

AU - Lewis, Simon

AU - Litvan, Irene

AU - Lyons, Kelly

AU - Martino, Davide

AU - Masellis, Mario

AU - Mochizuki, Hideki

AU - Morley, James F.

AU - Nirenberg, Melissa

AU - Odin, Per

AU - Pagonabarraga, Javier

AU - Panicker, Jalesh

AU - Pavese, Nicola

AU - Pekkonen, Eero

AU - Postuma, Ron

AU - Rodriguez Violante, Mayela

AU - Rosales, Raymond

AU - Schapira, Anthony

AU - Simuni, Tanya

AU - Stocchi, Fabrizio

AU - Storch, Alexander

AU - Subramanian, Indu

AU - Tagliati, Michele

AU - Tinazzi, Michele

AU - Toledo, Jon

AU - Tsuboi, Yoshio

AU - Walker, Richard

PY - 2024/12

Y1 - 2024/12

N2 - The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety in Parkinson’s disease (PD) are understudied. We identified clinical predictors of STN-DBS effects on anxiety in this study. In this prospective, open-label, multicentre study, we assessed patients with anxiety undergoing STN-DBS for PD preoperatively and at 6-month follow-up postoperatively. We assessed the Hospital Anxiety and Depression Scale (HADS-anxiety and depression subscales), Unified PD Rating Scale-motor examination, Scales for Outcomes in PD-motor (SCOPA-M)-activities of daily living (ADL) and -motor complications, Non-Motor Symptom Scale (NMSS), PDQuestionnaire-8 (PDQ-8), and levodopa-equivalent daily dose. We tested changes at follow-up with Wilcoxon signed-rank test and corrected for multiple comparisons (Bonferroni method). We identified patients with a clinically relevant anxiety improvement of anxiety based on a designated threshold of ½ standard deviation of baseline HADS-anxiety. Moreover, we investigated predictors of HADS-anxiety changes with correlations and linear regressions. We included 50 patients with clinically relevant baseline anxiety (i.e., HADS-anxiety ≥ 8) aged 63.1 years ± 8.3 with 10.4 years ± 4.5 PD duration. HADS-anxiety improved significantly at 6-month follow-up as 80% of our cohort experienced clinically relevant anxiety improvement. In predictor analyses, worse baseline SCOPA-ADL and NMSS-urinary domain were associated with greater HADS-anxiety improvements. HADS-anxiety and PDQ-8 changes correlated moderately. Worse preoperative ADL and urinary symptoms predicted favourable postoperative anxiety outcome, which in turn was directly proportionate to greater QoL improvement. This study highlights the importance of detailed anxiety assessments alongside other non-motor and motor symptoms when advising and monitoring patients undergoing STN-DBS for PD.

AB - The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety in Parkinson’s disease (PD) are understudied. We identified clinical predictors of STN-DBS effects on anxiety in this study. In this prospective, open-label, multicentre study, we assessed patients with anxiety undergoing STN-DBS for PD preoperatively and at 6-month follow-up postoperatively. We assessed the Hospital Anxiety and Depression Scale (HADS-anxiety and depression subscales), Unified PD Rating Scale-motor examination, Scales for Outcomes in PD-motor (SCOPA-M)-activities of daily living (ADL) and -motor complications, Non-Motor Symptom Scale (NMSS), PDQuestionnaire-8 (PDQ-8), and levodopa-equivalent daily dose. We tested changes at follow-up with Wilcoxon signed-rank test and corrected for multiple comparisons (Bonferroni method). We identified patients with a clinically relevant anxiety improvement of anxiety based on a designated threshold of ½ standard deviation of baseline HADS-anxiety. Moreover, we investigated predictors of HADS-anxiety changes with correlations and linear regressions. We included 50 patients with clinically relevant baseline anxiety (i.e., HADS-anxiety ≥ 8) aged 63.1 years ± 8.3 with 10.4 years ± 4.5 PD duration. HADS-anxiety improved significantly at 6-month follow-up as 80% of our cohort experienced clinically relevant anxiety improvement. In predictor analyses, worse baseline SCOPA-ADL and NMSS-urinary domain were associated with greater HADS-anxiety improvements. HADS-anxiety and PDQ-8 changes correlated moderately. Worse preoperative ADL and urinary symptoms predicted favourable postoperative anxiety outcome, which in turn was directly proportionate to greater QoL improvement. This study highlights the importance of detailed anxiety assessments alongside other non-motor and motor symptoms when advising and monitoring patients undergoing STN-DBS for PD.

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JO - npj Parkinson's Disease

JF - npj Parkinson's Disease

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M1 - 114

ER -

Predictors of short-term anxiety outcome in subthalamic stimulation for Parkinson’s disease

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