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Volume 8, Issue 6 J Neurol Neurosci
ISSN: 2171-6625 Neuro, an open access journal Neuroscience 2017
October 16-17, 2017
OCTOBER 16-17, 2017 OSAKA, JAPAN
17TH Global Neuroscience Conference
Burden of normality and deep brain stimulation for Parkinson’s disease: Amodel of psychosocial adjustment
Marc Baertschi1, Joao Flores Alves Dos Santos2, Michalina Radomska1, Kerstin Weber2 and Alessandra Canuto3
1University of Geneva, Switzerland
2Geneva University Hospitals, Switzerland
3Nant Foundation, Switzerland
Statement of the Problem: Deep Brain Stimulation (DBS) has become a leading treatment for alleviating the motor symptoms
of Parkinson’s disease (PD). Patients may nevertheless experience psychosocial maladjustment after surgery. Initially
conceptualized in epilepsy surgery, the burden of normality (BoN) has been viewed as an applicable model for addressing this
issue in DBS for PD; however, there is a lack of empirical data supporting this assumption.
Methodology & Theoretical Orientation: We reviewed the literature to identify elements of psychosocial maladjustment
in DBS for PD described in the three levels of the BoN: (1) precursory conditions: Chronic illness, sense of disablement and
chance for dramatic cure, (2) clinical manifestations of psychosocial maladjustment and (3) two mediating variables: Pre-
treatment expectations and discarding roles associated with pre-DBS PD. Next, we administered a DBS-adapted version of the
semi-structured Austin CEP interview-designed to assess the BoN in epilepsy to 19 patients aged 58.8±10.1 years treated with
DBS for PD.
Findings: The applicability of the BoN found strong support in the literature for each of the three levels, although no research
addressed sick roles. Similarly, patients from the pilot study fulfilled the precursory conditions with a disease duration of
11.3±3.5 years, a low pre-DBS quality of life (SF-36 means: PCS=38.1±7.2, MCS=39.8±7.4) and a significant improvement of
motor symptoms sustained in the long term (24.5±7.7 months, UPDRS-III: 28.5%, r=0.667, p=0.003). Qualitative data revealed
that psychosocial maladjustment was characterized by psychological, behavioral, affective and sociological symptoms, which
appeared to be fostered by unrealistic/ambivalent expectations and difficulties to forgo sick roles.
Conclusion & Significance: The BoN is useful to comprehend the post-DBS psychosocial maladjustment experienced by
patients with PD and could constitute a theoretical basis for clinical rehabilitation.
Biography
Marc Baertschi has been working under the supervision of Alessandra Canuto on the psychological predictors of quality of life in patients treated with deep brain
stimulation for a variety of movement disorders including Parkinson’s disease.
Marc Baertschi et al., J Neurol Neurosci 2017, 8:6
DOI: 10.21767/2171-6625-C1-006