The Persistence of Dopamine Dysregulation Syndrome after Pallidal Deep Brain Stimulation in Parkinson's Disease.

Background: Dopamine dysregulation syndrome (DDS) is a debilitating complication of Parkinson's disease (PD) dopamine replacement therapy (DRT) in which patients pathologically and/or compulsively use dopaminergic drugs to treat motor symptoms. Studies examining DDS outcomes following deep brain stimulation (DBS) are limited and have focused on subthalamic targeting.

Methods: Here, we present DDS outcomes in six patients from the Emory Movement Disorders clinic who underwent unilateral or bilateral DBS implantation of the globus pallidus internus (GPi). Despite motor improvements and/or initial reductions in DRT dosing, all six patients continued to meet clinical criteria for DDS 6 months post-surgery, displaying persistent pathological medication use, mood disturbances, and social impairment. Anxiety surrounding levodopa use was the most persistent DDS feature following surgery.

Conclusions: These results indicate that pallidal DBS is not a suitable treatment for DDS and its associated symptoms.