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

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Abstract
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 prospectively studied the follow-up from 3-months pre-surgery to 12-months post-surgery of 12 PD patients with pre-existing BA (9 with pathological gambling disorder, 2 with hypersexual disorder, and 1 with compulsive shopping disorder) in a multicenter study. Patients were assessed for BA, for 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. The STN is an interesting target for new therapeutic stimulation in BA and works to investigate the precise target in this neurobiological architecture should be performed in the future.