Title | Psychological functioning in Parkinson\'s disease post-deep brain stimulation: Self-regulation and executive functioning. | ||
Author | Combs, Hannah L; Garcia-Willingham, Natasha E; Berry, David T R; van Horne, Craig G; Segerstrom, Suzanne C | ||
Journal | J Psychosom Res | Publication Year/Month | 2018-Aug |
PMID | 29935753 | PMCID | -N/A- |
Affiliation + expend | 1.Department of Psychology, University of Kentucky, Lexington, KY, United States; Department of Neurology, Baylor College of Medicine, Houston, TX, United States. Electronic address: hlcombs@bcm.edu. |
Parkinson\'s disease (PD) is a neurodegenerative disorder involving the basal ganglia, resulting in motor and extra-motor deficits. These extra-motor deficits may be reflective of a self-regulatory deficit impacting patients\' ability to regulate cognitive processes, thoughts, behaviors, and emotions. There is a need to further examine the prevalence and range of self-regulation (SR) and executive functioning (EF) impairments in PD. This study sought to do so in a sample of patients with PD (N鈥?鈥?1) who underwent deep brain stimulation (DBS) surgery for motor symptom treatment. Patients completed measures indicative of SR and EF including neurocognitive tests, heart rate variability (HRV), and self-report questionnaires to examine these constructs in PD. The highest prevalence of impairments were observed for total impulse control disorder (ICD) symptoms (74%), depressive symptoms (48%), verbal fluency (phonemic: 39%; semantic: 36%), mental flexibility (32%), and self-reported SR impairments (Metacognition: 32%; Behavioral Regulation: 29%). Correlations among theoretically related constructs (i.e., SR, EF) were modest and variable; challenging the idea that SR is a unitary construct for which different domains depend on a common resource. In patients with PD post-DBS, higher resting HRV, thought to be indicative of better autonomic functioning, was linked to better EF in some instances but not others and not significantly associated with self-report SR. Overall, patients with PD exhibit various extra-motor deficits, ranging from subtle to severe. Health care professionals working with patients with PD should recognize the presence of extra-motor deficits, particularly ICDs, and obstacles that might arise from such impairments in patients\' daily lives.