Different psychological and quality-of-life outcomes after subthalamic nucleus deep brain stimulation in Parkinson's disease patients: a prospective study

Background: The present study aimed to evaluate changes in hopelessness, psychological well-being, and quality of life following subthalamic nucleus deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD). In addition, a secondary exploratory aim was to assess the role of anxiety and depression as predictors of psychological and quality-of-life outcomes after STN-DBS. Methods: This prospective pre-post study enrolled 70 patients with PD, of whom 64 underwent STN-DBS and were analyzed. The Beck Hopelessness Scale, Ryff's Psychological Well-Being Scale, Short Form-36 Health Survey, and motor (UPDRS-III) and medication-related (LEDD) data were assessed 30 days before STN-DBS (T0) and one year after STN-DBS (T1). In addition, the Beck Depression Inventory-II and State-Trait Anxiety Inventory-Form Y were administered at T0. Results: After STN-DBS, hopelessness increased in the feelings about the future subscale, and psychological well-being decreased in the autonomy and personal growth subscales. In contrast, quality of life improved in the physical and mental components and in the physical role, general health, and vitality subscales. Moreover, UPDRS-III and LEDD scores decreased. Changes in LEDD showed a concurrent association with the quality-of-life vitality subscale after STN-DBS, while anxiety and depression did not emerge as significant predictors. Conclusions: The findings suggest that although several quality-of-life dimensions in PD patients improve after STN-DBS, hopelessness related to future feelings and psychological well-being related to autonomy and personal growth worsen. A multidisciplinary approach that integrates neurological and psychological dimensions is essential for identifying, monitoring, and supporting patients who experience adverse psychological changes following STN-DBS.