Objective: The goal of this study is to identify behavior medicine variables in patients with ET and PD that can guide DBS surgical planning and post-operative management needs.

Background: The Millon Behavioral Medicine Diagnostic (MBMD) is a self-report inventory that evaluates health related behaviors including coping style and stress moderators in patients with neurological illness. Validated in neurological populations, MBMD data can predict patient compliance and treatment response. As deep brain stimulation (DBS) is a treatment option for symptom management in these medical conditions, there is utility in understanding how psychosocial backgrounds, behaviors, and attitudes can affect patient attitude toward surgery as well as prognosis.

Method: Patients who sought DBS intervention for either ET or PD were compared via independent t-test in demographic variables, psychological diagnosis at time of pre-DBS assessment, disease duration, self-reported HRQOL measures of Neurology-Quality of Life Social subscale (NeuroQoL-Social), Illness Conceptualization Questionnaire (ICQ), MBMD, and mood measures of BDI-II, PHQ-9 and GAD-7. All mean comparisons were analyzed at α = .05 level.

Results: There were clinical different response profiles between pre-DBS candidates with ET and PD. ET patients demonstrated a greater tendency to be domineering and tough-minded (Scale 6B: Forceful) than  the PD group. On Stress Moderators Subscales, the PD group consistently endorsed greater distress in areas of Illness Apprehension (A), Functional Deficits (B), Pain Sensitivity (C), Future Pessimism (E). Management Guides subscale of Adjustment Difficulties (L) was also significantly elevated in the PD group, as well as a lower level of social engagement captured by NeuroQoL-Social. Subscales A, C, and E were designed to reflect psychosocial issues subsumed under cognitive appraisal characteristics. Subscale B reflects patients’ ability to adjust to the demands of treatment and manage their disease. No differences in Treatment Prognostics subscales (G-K) were observed in between these two groups, noting no significant differences in behavioral aspects of a patient’s life that may complicate treatment efficacy.

Conclusion: There may be a greater need for, and emphasis on, care coordination including supportive counseling and/or patient education in pre-DBS patients with PD compared with patients with ET.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/behavior-medicine-perspectives-in-pre-dbs-patients-with-et-and-pd/