Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease
Identifieur interne : 000725 ( Istex/Curation ); précédent : 000724; suivant : 000726Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease
Auteurs : Aurélie Funkiewiez [France] ; Claire Ardouin [France] ; Paul Krack [France] ; Valérie Fraix [France] ; Nadège Van Blercom [France] ; Jing Xie [France] ; Elena Moro [France] ; Alim-Louis Benabid [France] ; Pierre Pollak [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2003-05.
English descriptors
Abstract
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. © 2003 Movement Disorder Society
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DOI: 10.1002/mds.10441
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2003-05">2003-05</date><biblScope unit="vol">18</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="524">524</biblScope><biblScope unit="page" to="530">530</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">A300B348DE718838110366E71FB11E28194C2609</idno><idno type="DOI">10.1002/mds.10441</idno><idno type="ArticleID">MDS10441</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>deep brain stimulation</term><term>euphoria</term><term>levodopa</term><term>mood</term><term>subthalamic nucleus</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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. © 2003 Movement Disorder Society</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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