Objective: To identify clinical predictors of the effect of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety in Parkinson’s Disease (PD).

Background: STN-DBS is a safe and effective treatment in patients with advanced PD improving quality of life, non-motor and motor symptoms. In PD, anxiety reduces quality of life. The effects of STN-DBS on anxiety in PD are understudied.

Method: In this prospective, open-label, multicenter study, we assessed PD patients with anxiety undergoing bilateral STN-DBS preoperatively and at 6-month follow-up postoperatively. The following clinical parameters were assessed: Hospital Anxiety and Depression Scale (HADS), Unified Parkinson’s Disease Rating Scale (UPDRS)-motor examination, Scales for Outcomes in PD-activities of daily living and -motor complications (SCOPA-B, -C), Non-Motor Symptom Scale (NMSS), PDQuestionnaire-8 Summary Index (PDQ-8 SI), and levodopa-equivalent daily dose total (LEDD). Predictors of anxiety (HADS-Anxiety (HADS-A)) changes were explored using Spearman correlations and linear regressions.

Results: In total, 50 PD patients with anxiety at baseline based on the cut-off established in the general population and in patients with PD (baseline score ≥ 8) were included in the final analysis. All clinical scales improved significantly at 6-month follow-up. Correlations and subsequent simple univariate linear regression analyses identified the following preoperative predictor variables for postoperative HADS-A improvement: more severe preoperative impairments of HADS total score (β = 0.36, p = 0.010), HADS-A (β = 0.40, p = 0.004), SCOPA-activities of daily living (β = 0.46, p < 0.001), and NMSS urinary domain (β = 0.31, p = 0.031). In a stepwise multiple univariate regression analysis, the variables SCOPA-activities of daily living and NMSS urinary domain remained statistically significant. The model accounted for 26.3% of the variance in HADS-A change postoperatively. Changes in HADS-A and PDQ-8 SI scores correlated (r = 0.47, p < 0.001).

Conclusion: We observed greater anxiety improvement in patients with worse baseline impairment of activities of daily living and urinary symptoms. Anxiety improvement was directly proportionate to quality of life improvement. This study emphasizes the importance of detailed motor and non-motor assessments in patients with anxiety undergoing STN-DBS for PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-of-short-term-anxiety-outcome-after-subthalamic-stimulation-in-parkinsons-disease/