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PLoS One. 2017 Apr 11;12(4):e0174512. doi: 10.1371/journal.pone.0174512. eCollection 2017.

Tackling psychosocial maladjustment in Parkinson's disease patients following subthalamic deep-brain stimulation: A randomised clinical trial.

Author information

Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.
AP-HP, Personalised Neurology & Psychiatry University Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Université Paris Est Créteil, Créteil, France.
Department of Mental Health and Psychiatry, Geneva University Hospital, University of Geneva, Geneva, Switzerland.
AP-HP, Groupe Hospitalier Pitie-Salpêtrière, Biostatistics Unit and Clinical Research Unit, Paris, France.
Sorbonne Universités, UPMC Univ Paris 06 UMR_S1136, and INSERM UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
AP-HP, Hôpital de la Salpêtrière, Genetic Department, Paris, France.
AP-HP, Hôpital de la Salpêtrière, Neurology Department, Paris, France.
AP-HP, Hôpital de la Salpêtrière, Centre d'Investigation Clinique, Paris, France.
AP-HP, Hôpital de la Salpêtrière, Neurosurgery Department, Paris, France.



Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for the motor and non-motor signs of Parkinson's disease (PD), however, psychological disorders and social maladjustment have been reported in about one third of patients after STN-DBS. We propose here a perioperative psychoeducation programme to limit such social and familial disruption.


Nineteen PD patients and carers were included in a randomised single blind study. Social adjustment scale (SAS) scores from patients and carers that received the psychoeducation programme (n = 9) were compared, both 1 and 2 years after surgery, with patients and carers with usual care (n = 10). Depression, anxiety, cognitive status, apathy, coping, parkinsonian disability, quality-of-life, carers' anxiety and burden were also analysed.


Seventeen patients completed the study, 2 were excluded from the final analysis because of adverse events. At 1 year, 2/7 patients with psychoeducation and 8/10 with usual care had an aggravation in at least one domain of the SAS (p = .058). At 2 years, only 1 patient with psychoeducation suffered persistent aggravated social adjustment as compared to 8 patients with usual care (p = .015). At 1 year, anxiety, depression and instrumental coping ratings improved more in the psychoeducation than in the usual care group (p = .038, p = .050 and p = .050, respectively). No significant differences were found between groups for quality of life, cognitive status, apathy or motor disability.


Our results suggest that a perioperative psychoeducation programme prevents social maladjustment in PD patients following STN-DBS and improves anxiety and depression compared to usual care. These preliminary data need to be confirmed in larger studies.

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