Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease

Autor: Pierre Pollak, Valérie Fraix, Paul Krack, Claire Ardouin, Aurélie Funkiewiez, Nadège Van Blercom, Alim-Louis Benabid, Jing Xie, Elena Moro
Rok vydání: 2003
Předmět:
Male
Parkinson's disease
medicine.medical_treatment
Neuropsychological Tests
Depressive Disorder
Major/diagnosis
Severity of Illness Index
Euphoriant
Functional Laterality
Antiparkinson Agents/administration & dosage/therapeutic use
Antiparkinson Agents
Levodopa
Levodopa/administration & dosage/therapeutic use
Surveys and Questionnaires
Activities of Daily Living
Cognition Disorders/diagnosis/physiopathology
Frontal Lobe/physiopathology
Parkinson Disease
Addiction Research Center Inventory
Middle Aged
Frontal Lobe
Subthalamic nucleus
Electric Stimulation Therapy/instrumentation
surgical procedures
operative
Neurology
Female
medicine.symptom
Psychology
therapeutics
Mania
medicine.drug
medicine.medical_specialty
Deep brain stimulation
Parkinson Disease/drug therapy/psychology/therapy
Psychomotor Disorders/diagnosis
Electric Stimulation Therapy
behavioral disciplines and activities
Time
Physical medicine and rehabilitation
Subthalamic Nucleus
medicine
Humans
Aged
Depressive Disorder
Major
Psychological Tests
medicine.disease
nervous system diseases
Subthalamic Nucleus/physiology
nervous system
Mood disorders
Neurology (clinical)
Psychomotor Disorders
Cognition Disorders
Neuroscience
Zdroj: Movement Disorders, Vol. 18, No 5 (2003) pp. 524-30
ISSN: 1531-8257
0885-3185
DOI: 10.1002/mds.10441
Popis: High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves the motor symptoms of Parkinson's disease (PD). Opposite changes in mood, such as mania or depression, have been reported after surgery, but it is not known whether these side effects are specifically related to STN DBS. To learn whether STN DBS also influences the limbic loop, we investigated acute subjective psychotropic effects related to levodopa or bilateral STN DBS. After a median postoperative follow-up of 12 months, 50 PD patients completed the Addiction Research Center Inventory (ARCI), assessing subjective psychotropic effects in four conditions: off-drug/on-stimulation; off-drug/off-stimulation; on-drug/off-stimulation; and on-drug/on-stimulation. Both levodopa and STN DBS improved all the ARCI subscales, indicating subjective feelings of well being, euphoria, increase in motivation, and decrease in fatigue, anxiety, and tension. A suprathreshold dose of levodopa was significantly more effective than STN DBS, using the same electrical parameters as for chronic stimulation, on four of the five ARCI subscales. We concluded that 1) both STN DBS and levodopa have synergistic acute beneficial psychotropic effects in PD, 2) the psychotropic effects of both treatments need to be considered in the long-term management of chronic STN DBS, and 3) the results indicate an involvement of the limbic STN in mood disorders of PD.
Databáze: OpenAIRE
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