Psychiatrische Nebenwirkungen der Tiefen Hirnstimulation bei idiopathischem Parkinsonsyndrom

Zusammenfassung

Mit der Tiefen Hirnstimulation (THS) steht seit den 90er-Jahren des 20. Jahrhunderts ein weiteres effektives Therapieverfahren für die Parkinsonerkrankung zur Verfügung, mit dem weltweit schon über fünfzigtausend Patienten behandelt wurden. Auch wenn die THS eine nebenwirkungsarme Methode ist, gibt es doch relevante unerwünschte Wirkungen, die besonders auch den psychiatrischen Bereich betreffen können. In der vorliegenden Arbeit soll ein umfassender Überblick über die Datenlage zu psychiatrischen Auswirkungen der THS bei Morbus Parkinson gegeben werden. Unter Verwendung einer systematischen Literaturrecherche (Suchzeitraum 1999 bis Februar 2011) wurden alle diesbezüglichen medizinischen Veröffentlichungen berücksichtigt. Dabei wurde offensichtlich, dass die ermittelten Studien hinsichtlich ihrer Methodik und der Ergebnisse höchst inkonsistent sind. Es zeichnet sich allerdings ab, dass postoperativ besondere Aufmerksamkeit einer erhöhten Suizidalität und affektiven Auslenkungen (sowohl zum depressiven als auch zum manischen Pol) gewidmet werden sollte. Hieraus ergibt sich die Empfehlung einer engmaschigen interdisziplinären prä- und postoperativen Evaluation von Parkinsonpatienten, die mittels THS behandelt wurden.

Abstract

Since the 1990 s deep brain stimulation (DBS) has provided an effective tool for the treatment of Parkinson’s disease. About fifty thousand Parkinson patients have been treated by DBS so far. Although a relatively safe intervention, there are still some considerable side effects, psychiatric and non-psychiatric. We conducted a structured search using PubMed and included publications from 1999 to February 2011 to provide an overview of the current data concerning psychiatric side effects of DBS in Parkinson’s disease. There was a tremendous variety and inconsistency concerning methods and results of the studies we included. However, it became apparent that postoperatively increased attention should be paid concerning a potentially increased suicidality and affective alterations (particularly manic states). We suggest frequent pre- and postoperative evaluations of Parkinson patients treated with DBS. 

Schlüsselwörter

Tiefe Hirnstimulation - Parkinson - psychiatrische Nebenwirkung - Suizidalität

Key words

deep brain stimulation - Parkinson’s disease - psychiatric side effects - suicidality

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