Objective: To explore the association of preoperative risk factors with postoperative suicidal ideation in patients with Parkinson’s disease (PD) who had deep brain stimulation (DBS) surgery.

Background: DBS therapy is increasingly used in the treatment of movement disorders such as PD, with excellent motoric outcomes. There is a low risk of psychiatric complications associated with DBS therapy, particularly with subthalamic nucleus target, including depression, mania, impulsivity, and suicidal ideation (SI) or behavior. However, this risk has not been well quantified to date.

Method: IRB approval was obtained. A retrospective chart review of 80 patients with PD who had DBS and were evaluated by UCSF Movement Disorders and Neuromodulation Center psychiatrist between October 2015 and June 2019 was conducted. Preoperative risk factors collected included patient-related factors (age at surgery, sex, age at PD diagnosis, marital status, current or past psychiatric symptoms: depression, mania, ICD, DDS, psychosis, substance use, SI, suicide attempts; type of psychiatric treatment received: medications, psychotherapy; family psychiatric history; medical comorbidities; and interpersonal stressors) and DBS-related factors (target, number of surgeries, laterality, surgical complications). Postoperative SI within 1 year of DBS surgery was assessed. Multivariate logistic regression was used to assess the association of preoperative risk factors with postoperative SI.

Results: No single preoperative risk factor was significantly associated with postoperative SI. A cumulative risk index was developed by adding current preoperative risk factors (anxiety, depression, ICD/DDS, substance use, SI, and interpersonal stressors); history of suicide attempts; and family history of suicide. Analysis is in progress; we will compare the cumulative risk index in patients with postoperative SI and those without SI.

Conclusion: The cumulative risk index may be a helpful tool in evaluating and counseling patients with PD and their families prior to DBS surgery. Our findings will need to be replicated in larger samples of patients with PD from other DBS centers.

References: 1. Lang A, Houeto JL, Krack P, et al. Deep brain stimulation: Preoperative issues. Mov Disord 2006;21:S171-S196 2. Seritan AL, Ureste P, Duong T, et al. Psychopharmacology for patients with Parkinson’s disease and deep brain stimulation: Lessons learned in an academic center. Curr Psychopharmacol 2019;8:41-54

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MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-of-suicidal-ideation-after-deep-brain-stimulation-surgery-in-patients-with-parkinsons-disease/