Psychiatric and neuropsychiatric adverse events associated with deep brain stimulation: A meta‐analysis of ten years' experience

  title={Psychiatric and neuropsychiatric adverse events associated with deep brain stimulation: A meta‐analysis of ten years' experience},
  author={Brian S. Appleby and Patrick S. Duggan and Alan Regenberg and Peter V. Rabins},
  journal={Movement Disorders},
Deep brain stimulation (DBS) has been approved by the FDA for use in the treatment of Parkinson's disease, essential tremor, and dystonia. Case reports and case series have reported significant psychiatric side effects in some individuals. The goal of this meta‐analysis is to characterize the risks and benefits of DBS and to assess its possible use within the psychiatric setting. A search was conducted on PubMed, EBSCO, and PsycInfo in January 2006 that covered the time period 1 Jan 1996–30 Dec… 
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Bilateral STN DBS can have a negative impact on various aspects of frontal executive functioning, especially in patients older than 69 years, and the possible reversibility of these effects by turning the DBS off is examined.
Neuropsychological functioning following bilateral subthalamic nucleus stimulation in Parkinson's disease.
  • C. MorrisonJ. Borod C. Olanow
  • Psychology
    Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists
  • 2004
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This study confirms the great value of subthalamic nucleus stimulation in the treatment of intractable PD and indicates some adverse events such as depression may be taken into account in the inclusion criteria and also in the post-operative outcome.