Project Summary

David E. Hardesty, M.D. (Young Investigator 2005) of New York State Psychiatric Institute and Columbia University, plans to study why there has been an increase in the number of suicides by Parkinson’s disease patients after they get deep brain stimulation (DBS), a treatment which often successfully controls their symptoms. DBS has been a great advance in Parkinson’s disease treatment. It is primarily used to control motor fluctuations, a common problem after five years on levodopa therapy. Mood, quality of life, and independence typically improve alongside motor function. But subthalamic nucleus stimulation (STN) with DBS can also produce immediate and dramatic psychiatric reactions, such as mania, aggression, impulsivity, and melancholic depression. These symptoms are usually reversible, reproducible, and modifiable through DBS adjustments. Recently, however, clinicians have noted startling reports of frequent suicide from people who underwent DBS. Dr. Hardesty plans to study the acute effects of DBS on mood and impulsivity with specific consideration of suicide risk. He also will assess the laterality of DBS effects, and the influence of levodopa and other dopaminergic medications on these outcomes. The goal is to determine the neurophysiological mechanisms that contribute to suicide following STN DBS. A broader aim is to use this opportunity to observe an anatomically specific, reversible intervention to understand serious affective illness and suicidal behavior. Through such work it may be possible to develop novel treatments to prevent such tragic outcomes.

Program Area: MULTIPLE FOCUS AREAS\Bipolar Disorder/Schizophrenia\Parkinson's Associated Depression

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