Objective: To characterize psychological traits in patients who pursue focused ultrasound (FUS) versus deep brain stimulation (DBS) for tremor management

Background: Psychosocial characteristics can determine attitudes toward medical intervention and treatment prognosis. The Millon Behavioral Medicine Diagnostic (MBMD) has been used to characterize such traits in pre-DBS patients with PD, although no data exist regarding FUS candidates.

Method: Patients with ET and PD presenting to our center for FUS or DBS surgery were compared using independent t-test for demographics, psychological diagnosis at time of pre-op exam, disease duration, self-reported HRQOL measures (Neurology-Quality of Life Social subscale, Illness Conceptualization Questionnaire (ICQ), MBMD, and mood measures (BDI-II, PHQ-9 GAD-7). Mean difference significance testing was set to α = .05. Data trends were set at α = .10 level.

Results: Patients seeking FUS are significantly more likely to be not married, and those pursuing DBS report feeling more pessimistic and dejected than the FUS group. There was a trend for FUS candidates to have coping mechanisms that allow them to be more sociable, confident, domineering, and tough-minded. Patients opting for DBS reported a trend toward feeling more socially isolated than the FUS group. DBS candidates also trended towards being more dis-inclined to follow medical recommendations.

Conclusion: Level of psychosocial support might dictate the type of surgery that patients select, with FUS seemingly more appealing than DBS to those without a partner. Those pursuing DBS seem to experience significant pessimism and greater social isolation, and there could be utility of counseling and patient education for optimizing prognosis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/behavioral-health-characteristics-of-pre-surgical-focused-ultrasound-and-deep-brain-stimulation-candidates/