Impact of Deep Brain Stimulation on Addictive Behaviors A Case Series of Parkinsonians Patients

Deep brain stimulation of the Subthalamic Nucleus (STN-DBS) is a recognized treatment in Parkinson’s disease (PD), but knowledge is still limited regarding its possible impact on patients with Behavioral Addiction (BA) who undergo surgery. To assess this effect of STN-DBS, we carried out a prospective study of the follow-up of 12 PD patients with pre-existing BA (9 with pathological gambling disorder, 2 with hypersexual disorder, and 1 with compulsive shopping disorder), from 3-months pre-surgery to 12-months post-surgery, in a multicenter study. The patients were assessed for BA, mental status with anxiety, depression, mania, emotional process and for PD, using the Unified Parkinson’s Disease Rating Scale Motor Examination (UPDRS3) and cumulative daily L-Dopa Equivalent Daily Dose (LEDD). Mean 6 and 12-month post-surgery scores were compared to baseline. After one year of STN-DBS, our results indicated that the treatment remained generally effective and stable. There was no effect on mania state or negative impact on motor signs. A significant improvement of the anxiety score was also observed. STN is an interesting target for new therapeutic stimulation in BA and more works performed to investigate this neurobiological architecture should be performed in the future.