Deep Brain Stimulation and Changes in “Personality”: A Catch-All with Merits and Pitfalls
Abstract
The 30 anniversary of the first DBS surgery of the subthalamic nucleus (STN) for Parkinson’s disease was celebrated in Grenoble this June. Since this initial surgery, the application of DBS has expanded far beyond the STN and Parkinson’s disease, to a range of neuroanatomical sites and neurological and neuropsychiatric conditions. DBS technology has advanced considerably, including the emergence of closed-loop systems (adaptive DBS). Through its scientific and technological developments, a controversial topic that has followed DBS is whether it can result in patient personality change. Reported cases within scientific literature have been sparse, yet the issue has garnered substantial attention within the field of bioethics and popular media. As reported in Zuk et al. (2023), opinions are mixed on the appropriateness of the term “personality” to describe post-DBS experiences. Here we examine the benefits and drawbacks of the term, considered through the lens of informed consent and communications between treatment teams, DBS recipients, and families. Personality is broadly understood to be an individual’s unique and enduring habits of thinking, feeling, and behaving. In essence, what makes a person “them.” In this sense, personality is a catch-all that covers the breadth of changes that have been described following DBS. This may include changes in cognition (impulsive decision-making, poor concentration, confusion), mood (irritability, euphoria, depression), and behavior…
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