medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2020-33-13-17medalphabet-1838Research ArticleСтатьиДепрессия и дофаминовый дизрегуляционный синдром как фактор риска суицида на фоне стимуляции подкорковых структур при болезни ПаркинсонаDepression and dopamine dysregulation syndrome as risk factor for suicide after deep brain stimulation in Parkinson's diseaseБрильЕ. В.BrilE. V.

к.м.н., гл. внештатный невролог ФМБА России, зав. кафедрой неврологии с курсом нейрохирургии МБУ ИНО; доцент кафедры неврологии РМАНПО, рук. Федерального неврологического центра экстрапирамидных заболеваний и психического здоровья

Москва

Moscow

АббасовФ. А.AbbasovF. A.

врач-невролог Федерального неврологического центра экстрапирамидных заболеваний и психического здоровья

Москва

Moscow

ЗимняковаА. С.ZimnyakovaO. S.

к.м.н., доцент кафедры неврологии с курсом нейрохирургии МБУ ИНО

Москва

Moscow

АникинаМ. А.AnikinaM. A.

к. м. н., ассистент кафедры неврологии с курсом нейрохирургии МБУ ИНО

Москва

Moscow

КесаревД. Г.KesarevD. G.

аспирант кафедры неврологии с курсом нейрохирургии МБУ ИНО

Москва

Moscow

ФГБУ «Государственный научный центр Российской Федерации – Федеральный медицинский биофизический центр имени А. И. Бурназяна» ФМБА России; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияState Scientific Centre of the Russian Federation – Federal Medical Biophysical Centre n. a. A. I. Burnazyan; Russian Medical Academy for Continuing Professional EducationRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy for Continuing Professional EducationRussian FederationФГБУ «Государственный научный центр Российской Федерации – Федеральный медицинский биофизический центр имени А. И. Бурназяна» ФМБА РоссииРоссияState Scientific Centre of the Russian Federation – Federal Medical Biophysical Centre n. a. A. I. BurnazyanRussian Federation202014012021033Неврология и психиатрия (4)1317Copyright © Бриль Е.В., Аббасов Ф.А., Зимнякова А.С., Аникина М.А., Кесарев Д.Г., 20212021Бриль Е.В., Аббасов Ф.А., Зимнякова А.С., Аникина М.А., Кесарев Д.Г.Bril E.V., Abbasov F.A., Zimnyakova O.S., Anikina M.A., Kesarev D.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1838

Современные подходы к лечению развернутых стадий болезни Паркинсона включают в себя глубокую стимуляцию головного мозга (deep brain stimulation, DBS). Ключевым фактором, обеспечивающим эффективность и безопасность данного метода, является адекватный отбор кандидатов на DBS. Критерии отбора пациентов в основном базируются на данных крупных многоцентровых исследований. Известно, что применение DBS может сопровождаться развитием нежелательных эффектов, наиболее распространенными из которых являются нейропсихиатрические нарушения. Самоубийство является крайним проявлением нейропсихиатрических нарушений и потенциально обратимой причиной смерти пациентов с болезнью Паркинсона. У пациентов с хроническими заболеваниями, в том числе неврологическими, имеется повышенный риск самоубийств или их попыток. Депрессия и нарушение импульсного контроля после DBS STN, вероятно, являются ключевыми факторами, влияющими на суицидальное поведение у пациентов. Авторы представляют литературный обзор, посвященный суициду при болезни Паркинсона, а также на фоне DBS c описанием собственного клинического случая – попытки совершения самоубийства после проведения DBS с разбором факторов, повлиявших на развитие суицидального поведения, а также с разбором тактики коррекции нейропсихиатрических нарушений.

Modern approaches to the management of advanced stages of Parkinson's disease include deep brain stimulation (DBS). Adequate selection of candidates for DBS is a key factor for the effectiveness and safety of this method. Selection criteria are mainly based on data from large multicenter studies. It is known that the use of DBS can be accompanied by the development of side effects, the most common of which is neuropsychiatric disorders. Suicide is an extreme manifestation of neuropsychiatric disorders and a potentially reversible cause of death in patients with Parkinson's disease. Patients with chronic diseases, including neurological diseases, have an increased risk of suicide or suicide attempts. Depression and impulse control disorders following DBS are likely key contributors to suicidal behavior in patients. The authors present a clinical case – an attempt to commit suicide after DBS with the use of levodopa with an analysis of the factors contributing the development of suicidal behavior and an analysis of the management of neuropsychiatric disorders.

болезнь ПаркинсонасуициднейромодуляцияDBSдепрессиядофаминовая дизрегуляцияParkinson's diseasesuicideneuromodulationDBSdepressiondopamine dysregulationReferencesGrimes D, Fitzpatrick M, Gordon J, et al. Canadian guideline for Parkinson disease. CMAJ. 2019; 191 (36): E 989–E 1004.Grimes D, Fitzpatrick M, Gordon J, et al. Canadian guideline for Parkinson disease. CMAJ. 2019; 191 (36): E 989–E 1004.Иллариошкин С. Н., Федотова Е. Ю., Селиверстов Ю. А. Возможности инвазивных методов лечения развернутых стадий Болезни Паркинсона. Методические рекомендации. Москва, 2016. http://parkinsonizm.ru/files/InvasiveTreatmentPD.pdfИллариошкин С. Н., Федотова Е. Ю., Селиверстов Ю. А. Возможности инвазивных методов лечения развернутых стадий Болезни Паркинсона. Методические рекомендации. Москва, 2016. http://parkinsonizm.ru/files/InvasiveTreatmentPD.pdf[Illarioshkin S, Fedotova E., Seliverstov Y. Possibilities of invasive methods of treatment of advanced stages of Parkinson's disease. Guidelines. Moscow, 2016][Illarioshkin S, Fedotova E., Seliverstov Y. Possibilities of invasive methods of treatment of advanced stages of Parkinson's disease. Guidelines. Moscow, 2016]Fox SH, Katzenschlager R, Lim SY, et al. Movement Disorder Society Evidence-Based Medicine Committee. International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson's disease. Mov Disord. 2018 Aug; 33 (8): 1248–1266.Fox SH, Katzenschlager R, Lim SY, et al. Movement Disorder Society Evidence-Based Medicine Committee. International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson's disease. Mov Disord. 2018 Aug; 33 (8): 1248–1266.Lhommée E, Wojtecki L, Czernecki V, et al. EARLYSTIM study group. Behavioural outcomes of subthalamic stimulation and medical therapy versus medical therapy alone for Parkinson's disease with early motor complications (EARLYSTIM trial): secondary analysis of an open-label randomised trial. Lancet Neurol. 2018 Mar; 17 (3): 223–231.Lhommée E, Wojtecki L, Czernecki V, et al. EARLYSTIM study group. Behavioural outcomes of subthalamic stimulation and medical therapy versus medical therapy alone for Parkinson's disease with early motor complications (EARLYSTIM trial): secondary analysis of an open-label randomised trial. Lancet Neurol. 2018 Mar; 17 (3): 223–231.Voon V, Krack P, Lang AE, et al. A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease. Brain. 2008 Oct; 131 (Pt 10): 2720–8.Voon V, Krack P, Lang AE, et al. A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease. Brain. 2008 Oct; 131 (Pt 10): 2720–8.Weintraub D, Duda JE, Carlson K, et al. Suicide ideation and behaviours after STN and GPi DBS surgery for Parkinson's disease: results from a randomised, controlled trial. J Neurol Neurosurg Psychiatry. 2013 Oct; 84 (10): 1113–8.Weintraub D, Duda JE, Carlson K, et al. Suicide ideation and behaviours after STN and GPi DBS surgery for Parkinson's disease: results from a randomised, controlled trial. J Neurol Neurosurg Psychiatry. 2013 Oct; 84 (10): 1113–8.Arciniegas DB, Anderson CA. Suicide in Neurologic Illness. Curr Treat Options Neurol. 2002 Nov; 4 (6): 457–468.Arciniegas DB, Anderson CA. Suicide in Neurologic Illness. Curr Treat Options Neurol. 2002 Nov; 4 (6): 457–468.Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967 May; 17 (5): 427–42.Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967 May; 17 (5): 427–42.Stensman R, Sundqvist-Stensman UB. Physical disease and disability among 416 suicide cases in Sweden. Scand J Soc Med. 1988; 16 (3): 149–153.Stensman R, Sundqvist-Stensman UB. Physical disease and disability among 416 suicide cases in Sweden. Scand J Soc Med. 1988; 16 (3): 149–153.Lee H, Myung W, Lee C, et al. Clinical epidemiology of long-term suicide risk in a nationwide population-based cohort study in South Korea. J Psychiatr Res. 2018;100: 47–55.Lee H, Myung W, Lee C, et al. Clinical epidemiology of long-term suicide risk in a nationwide population-based cohort study in South Korea. J Psychiatr Res. 2018;100: 47–55.Lee T, Lee HB, Ahn MH, et al. Increased suicide risk and clinical correlates of suicide among patients with Parkinson’s disease. Park Relat Disord. 2016; 32: 102–107.Lee T, Lee HB, Ahn MH, et al. Increased suicide risk and clinical correlates of suicide among patients with Parkinson’s disease. Park Relat Disord. 2016; 32: 102–107.Roberts S, John A, Kandalama U, et al. Suicide following acute admissions for physical illnesses across England and Wales. Psychol Med. 2018; 48: 578–591.Roberts S, John A, Kandalama U, et al. Suicide following acute admissions for physical illnesses across England and Wales. Psychol Med. 2018; 48: 578–591.Kostić VS, Pekmezović T, Tomić A, et al. Suicide and suicidal ideation in Parkinson’s disease. J Neurol Sci. 2010; 289 (1): 40–43.Kostić VS, Pekmezović T, Tomić A, et al. Suicide and suicidal ideation in Parkinson’s disease. J Neurol Sci. 2010; 289 (1): 40–43.Myslobodsky M, Lalonde FM, Hicks L. Are patients with Parkinson's disease suicidal? J Geriatr Psychiatry Neurol. 2001 Fall; 14 (3): 120–4.Myslobodsky M, Lalonde FM, Hicks L. Are patients with Parkinson's disease suicidal? J Geriatr Psychiatry Neurol. 2001 Fall; 14 (3): 120–4.Du J, Liu X, Zhou X, et al. Parkinson's Disease-Related Risk of Suicide and Effect of Deep Brain Stimulation: Meta-Analysis. Parkinsons Dis. 2020; 2020: 8091963.Du J, Liu X, Zhou X, et al. Parkinson's Disease-Related Risk of Suicide and Effect of Deep Brain Stimulation: Meta-Analysis. Parkinsons Dis. 2020; 2020: 8091963.Kummer A, Cardoso F, Teixeira AL. Suicidal ideation in Parkinson's disease. CNS Spectr. 2009 Aug; 14 (8): 431–6.Kummer A, Cardoso F, Teixeira AL. Suicidal ideation in Parkinson's disease. CNS Spectr. 2009 Aug; 14 (8): 431–6.Schüpbach MW, Welter ML, Bonnet AM, et al. Mortality in patients with Parkinson's disease treated by stimulation of the subthalamic nucleus. Mov. Disord. 2007 Jan 15; 22 (2): 257–61.Schüpbach MW, Welter ML, Bonnet AM, et al. Mortality in patients with Parkinson's disease treated by stimulation of the subthalamic nucleus. Mov. Disord. 2007 Jan 15; 22 (2): 257–61.Toft M, Lilleeng B, Ramm-Pettersen J, et al. Long-term efficacy and mortality in Parkinson's disease patients treated with subthalamic stimulation. Mov. Disord. 2011 Aug 15; 26 (10): 1931–4.Toft M, Lilleeng B, Ramm-Pettersen J, et al. Long-term efficacy and mortality in Parkinson's disease patients treated with subthalamic stimulation. Mov. Disord. 2011 Aug 15; 26 (10): 1931–4.Li W, Abbas MM, Acharyya S, et al. Suicide in Parkinson's Disease. Mov Disord Clin Pract. 2018; 5 (2): 177–182.Li W, Abbas MM, Acharyya S, et al. Suicide in Parkinson's Disease. Mov Disord Clin Pract. 2018; 5 (2): 177–182.Mainio A, Karvonen K, Hakko H, et al. Parkinson's disease and suicide: a profile of suicide victims with Parkinson's disease in a population-based study during the years 1988–2002 in Northern Finland. Int J Geriatr Psychiatry. 2009 Sep; 24 (9): 916–20.Mainio A, Karvonen K, Hakko H, et al. Parkinson's disease and suicide: a profile of suicide victims with Parkinson's disease in a population-based study during the years 1988–2002 in Northern Finland. Int J Geriatr Psychiatry. 2009 Sep; 24 (9): 916–20.Juurlink DN, Herrmann N, Szalai JP, et al. Medical Illness and the Risk of Suicide in the Elderly. Arch Intern Med. 2004; 164 (11): 1179–1184.Juurlink DN, Herrmann N, Szalai JP, et al. Medical Illness and the Risk of Suicide in the Elderly. Arch Intern Med. 2004; 164 (11): 1179–1184.Soulas T, Gurruchaga JM, Palfi S, et al. Attempted and completed suicides after subthalamic nucleus stimulation for Parkinson's disease. J Neurol Neurosurg Psychiatry. 2008 Aug; 79 (8): 952–4.Soulas T, Gurruchaga JM, Palfi S, et al. Attempted and completed suicides after subthalamic nucleus stimulation for Parkinson's disease. J Neurol Neurosurg Psychiatry. 2008 Aug; 79 (8): 952–4.Tröster AI, Fields JA, Wilkinson S, et al. Effect of motor improvement on quality of life following subthalamic stimulation is mediated by changes in depressive symptomatology. Stereotact Funct Neurosurg. 2003; 80 (1–4): 43–7.Tröster AI, Fields JA, Wilkinson S, et al. Effect of motor improvement on quality of life following subthalamic stimulation is mediated by changes in depressive symptomatology. Stereotact Funct Neurosurg. 2003; 80 (1–4): 43–7.Giannini G, Francois M, Lhommée E, et al. Suicide and suicide attempts after subthalamic nucleus stimulation in Parkinson disease. Neurology. 2019 Jul 2; 93 (1): e97–e105.Giannini G, Francois M, Lhommée E, et al. Suicide and suicide attempts after subthalamic nucleus stimulation in Parkinson disease. Neurology. 2019 Jul 2; 93 (1): e97–e105.Evans AH, Strafella AP, Weintraub D, et al. Impulsive and compulsive behaviors in Parkinson's disease. Mov Disord. 2009 Aug 15; 24 (11): 1561–70.Evans AH, Strafella AP, Weintraub D, et al. Impulsive and compulsive behaviors in Parkinson's disease. Mov Disord. 2009 Aug 15; 24 (11): 1561–70.Buhmann C, Huckhagel T, Engel K, et al. Adverse events in deep brain stimulation: A retrospective long-term analysis of neurological, psychiatric and other occurrences. PLoS One. 2017 Jul 5; 12 (7): e0178984.Buhmann C, Huckhagel T, Engel K, et al. Adverse events in deep brain stimulation: A retrospective long-term analysis of neurological, psychiatric and other occurrences. PLoS One. 2017 Jul 5; 12 (7): e0178984.Schuepbach WM, Rau J, Knudsen K, et al. Neurostimulation for Parkinson's disease with early motor complications. N Engl J Med. 2013 Feb 14; 368 (7): 610–22.Schuepbach WM, Rau J, Knudsen K, et al. Neurostimulation for Parkinson's disease with early motor complications. N Engl J Med. 2013 Feb 14; 368 (7): 610–22.Омарова C. М., Федорова Н. В., Томский А. А. и соавт. Синдром дофаминовой дизрегуляции и хроническая стимуляция субталамического ядра при болезни Паркинсона. Журнал неврологии и психиатрии им. С. С. Корсакова. 2017; 117 (12): 27–32. [Omarova S. M., N. V. Fedorova N. V., Tomskiy A. A. et al. Syndrome dopamine dysregulation and deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Korsakov Journal of Neurology and Psychiatry. 2017; 117 (12): 27–32]Омарова C. М., Федорова Н. В., Томский А. А. и соавт. Синдром дофаминовой дизрегуляции и хроническая стимуляция субталамического ядра при болезни Паркинсона. Журнал неврологии и психиатрии им. С. С. Корсакова. 2017; 117 (12): 27–32. [Omarova S. M., N. V. Fedorova N. V., Tomskiy A. A. et al. Syndrome dopamine dysregulation and deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Korsakov Journal of Neurology and Psychiatry. 2017; 117 (12): 27–32]Smeding HM, Goudriaan AE, Foncke EM, et al. Pathological gambling after bilateral subthalamic nucleus stimulation in Parkinson disease. J Neurol Neurosurg Psychiatry. 2007; 78 (5): 517–519.Smeding HM, Goudriaan AE, Foncke EM, et al. Pathological gambling after bilateral subthalamic nucleus stimulation in Parkinson disease. J Neurol Neurosurg Psychiatry. 2007; 78 (5): 517–519.

The authors declare that there are no conflicts of interest present.