Apathy following subthalamic stimulation in Parkinson disease: A dopamine responsive symptom
Identifieur interne : 003579 ( Main/Merge ); précédent : 003578; suivant : 003580Apathy following subthalamic stimulation in Parkinson disease: A dopamine responsive symptom
Auteurs : Virginie Czernecki [France] ; Michael Schüpbach [France, Suisse] ; Sadek Yaici [France] ; Richard Lévy [France] ; Eric Bardinet [France] ; Jérôme Yelnik [France] ; Bruno Dubois [France] ; Yves Agid [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2008-05-15.
English descriptors
- KwdEn :
- Aged, Deep Brain Stimulation (adverse effects), Dopamine Agonists (therapeutic use), Female, Humans, Indoles (pharmacology), Indoles (therapeutic use), Male, Middle Aged, Mood Disorders (etiology), Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson Disease (psychology), Parkinson disease, Receptors, Dopamine D2 (drug effects), Receptors, Dopamine D3 (drug effects), Subthalamic Nucleus (physiopathology), apathy, dopaminergic agonist, subthalamic stimulation.
- MESH :
- chemical , drug effects : Receptors, Dopamine D2, Receptors, Dopamine D3.
- chemical , pharmacology : Indoles.
- chemical , therapeutic use : Dopamine Agonists, Indoles.
- adverse effects : Deep Brain Stimulation.
- drug therapy : Parkinson Disease.
- etiology : Mood Disorders.
- physiopathology : Parkinson Disease, Subthalamic Nucleus.
- psychology : Parkinson Disease.
- Aged, Female, Humans, Male, Middle Aged.
Abstract
To evaluate the effects of the dopamine D2‐D3 agonist ropinirole in patients who developed apathy after complete withdrawal from dopaminergic medication following successful subthalamic nucleus (STN) stimulation for advanced Parkinson disease (PD). We assessed apathy (Apathy Scale, Apathy Inventory), mood (Montgomery‐Åsberg Depression Rating Scale), cognitive functions (Mattis Dementia rating scale, frontal score, executive tests) and motor state (UPDRS‐III) in 8 PD patients treated with STN stimulation without dopaminergic treatment and who became apathetic. Assessments were made at baseline and after 6 weeks of ropinirole treatment (7.2 ± 5.9 mg/d; range 1–18 mg/d). Apathy improved with ropinirole in all but 1 patient (54 ± 24%; range 0–78%). Mood also improved (75 ± 31%; range 0–100%), but not in correlation with the change in apathy. Cognitive performance was not modified. Stimulation contacts were located within the STN in all patients except the one who remained apathetic in spite of ropinirole treatment (zona incerta). We suggest that apathy, which was compensated for by an enhancement of D2‐D3 receptor stimulation in PD patients with STN stimulation: (1) depends on a dopaminergic deficit in associativo‐limbic areas of the brain and (2) can be avoided if a dopaminergic agonist is administered postoperatively. © 2008 Movement Disorder Society
Url:
- https://api.istex.fr/document/ED91C023356D1D4FFF7501D9DD48101CF35B1793/fulltext/pdf
- https://hal.inria.fr/hal-00805452
DOI: 10.1002/mds.21949
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ISTEX:ED91C023356D1D4FFF7501D9DD48101CF35B1793Le document en format XML
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We assessed apathy (Apathy Scale, Apathy Inventory), mood (Montgomery‐Åsberg Depression Rating Scale), cognitive functions (Mattis Dementia rating scale, frontal score, executive tests) and motor state (UPDRS‐III) in 8 PD patients treated with STN stimulation without dopaminergic treatment and who became apathetic. Assessments were made at baseline and after 6 weeks of ropinirole treatment (7.2 ± 5.9 mg/d; range 1–18 mg/d). Apathy improved with ropinirole in all but 1 patient (54 ± 24%; range 0–78%). Mood also improved (75 ± 31%; range 0–100%), but not in correlation with the change in apathy. Cognitive performance was not modified. Stimulation contacts were located within the STN in all patients except the one who remained apathetic in spite of ropinirole treatment (zona incerta). We suggest that apathy, which was compensated for by an enhancement of D2‐D3 receptor stimulation in PD patients with STN stimulation: (1) depends on a dopaminergic deficit in associativo‐limbic areas of the brain and (2) can be avoided if a dopaminergic agonist is administered postoperatively. © 2008 Movement Disorder Society</div></front></TEI><double doi="10.1002/mds.21949"><HAL><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Apathy following subthalamic stimulation in Parkinson disease: a dopamine responsive symptom.</title><author><name sortKey="Czernecki, Virginie" sort="Czernecki, Virginie" uniqKey="Czernecki V" first="Virginie" last="Czernecki">Virginie Czernecki</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-188430" status="INCOMING"><orgName>Centre De Référence National 'Syndrome Gilles de la Tourette', Pôle des Maladies du Système Nerveux, Groupe Hospitalier Pitié-Salpêtrière</orgName><desc><address><addrLine>Paris</addrLine><country key="FR"></country></address></desc><listRelation><relation active="#struct-300068" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-300068" type="direct"><org type="institution" xml:id="struct-300068" status="VALID"><orgName>Assistance publique - 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Hôpitaux de Paris (AP-HP)</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-3037" status="VALID"><orgName>Neurologie et thérapeutique expérimentale</orgName><desc><address><addrLine>GH Pitié-Salpetrière 47, Boulevard de L'Hopital 75651 PARIS CEDEX 13</addrLine><country key="FR"></country></address><ref type="url">http://www.u289.ifrns.chups.jussieu.fr/</ref></desc><listRelation><relation active="#struct-93591" type="direct"></relation><relation name="U679" active="#struct-300002" type="direct"></relation><relation active="#struct-300636" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-93591" type="direct"><org type="institution" xml:id="struct-93591" status="VALID"><orgName>Université Pierre et Marie Curie - 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The French Aerospace Lab</orgName><orgName type="acronym">Chatillon</orgName><desc><address><addrLine>F-92322 Chatillon</addrLine><country key="FR"></country></address><ref type="url">http://www.onera.fr</ref></desc><listRelation><relation active="#struct-300024" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-300024" type="direct"><org type="institution" xml:id="struct-300024" status="VALID"><orgName>ONERA</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Bardinet, Eric" sort="Bardinet, Eric" uniqKey="Bardinet E" first="Eric" last="Bardinet">Eric Bardinet</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-81470" status="OLD"><orgName>Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière [Paris]</orgName><orgName type="acronym">CRICM</orgName><desc><address><addrLine>GH Pitié-Salpêtrière 47, boulevard de l'Hôpital 75651 Paris cedex 13</addrLine><country key="FR"></country></address><ref type="url">http://www.cricm.upmc.fr/</ref></desc><listRelation><relation active="#struct-93591" type="direct"></relation><relation name="U975" active="#struct-300002" type="direct"></relation><relation name="UMR7225" active="#struct-441569" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-93591" type="direct"><org type="institution" xml:id="struct-93591" status="VALID"><orgName>Université Pierre et Marie Curie - Paris 6</orgName><orgName type="acronym">UPMC</orgName><desc><address><addrLine>4 place Jussieu - 75005 Paris</addrLine><country key="FR"></country></address><ref type="url">http://www.upmc.fr/</ref></desc></org></tutelle><tutelle name="U975" active="#struct-300002" type="direct"><org type="institution" xml:id="struct-300002" status="VALID"><orgName>INSERM</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle><tutelle name="UMR7225" active="#struct-441569" type="direct"><org type="institution" xml:id="struct-441569" status="VALID"><idno type="IdRef">02636817X</idno><idno type="ISNI">0000000122597504</idno><orgName>Centre National de la Recherche Scientifique</orgName><orgName type="acronym">CNRS</orgName><date type="start">1939-10-19</date><desc><address><country key="FR"></country></address><ref type="url">http://www.cnrs.fr/</ref></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérôme" last="Yelnik">Jérôme Yelnik</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-81470" status="OLD"><orgName>Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière [Paris]</orgName><orgName type="acronym">CRICM</orgName><desc><address><addrLine>GH Pitié-Salpêtrière 47, boulevard de l'Hôpital 75651 Paris cedex 13</addrLine><country key="FR"></country></address><ref type="url">http://www.cricm.upmc.fr/</ref></desc><listRelation><relation active="#struct-93591" type="direct"></relation><relation name="U975" active="#struct-300002" type="direct"></relation><relation name="UMR7225" active="#struct-441569" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-93591" type="direct"><org type="institution" xml:id="struct-93591" status="VALID"><orgName>Université Pierre et Marie Curie - Paris 6</orgName><orgName type="acronym">UPMC</orgName><desc><address><addrLine>4 place Jussieu - 75005 Paris</addrLine><country key="FR"></country></address><ref type="url">http://www.upmc.fr/</ref></desc></org></tutelle><tutelle name="U975" active="#struct-300002" type="direct"><org type="institution" xml:id="struct-300002" status="VALID"><orgName>INSERM</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle><tutelle name="UMR7225" active="#struct-441569" type="direct"><org type="institution" xml:id="struct-441569" status="VALID"><idno type="IdRef">02636817X</idno><idno type="ISNI">0000000122597504</idno><orgName>Centre National de la Recherche Scientifique</orgName><orgName type="acronym">CNRS</orgName><date type="start">1939-10-19</date><desc><address><country key="FR"></country></address><ref type="url">http://www.cnrs.fr/</ref></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Dubois, Bruno" sort="Dubois, Bruno" uniqKey="Dubois B" first="Bruno" last="Dubois">Bruno Dubois</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-81470" status="OLD"><orgName>Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière [Paris]</orgName><orgName type="acronym">CRICM</orgName><desc><address><addrLine>GH Pitié-Salpêtrière 47, boulevard de l'Hôpital 75651 Paris cedex 13</addrLine><country key="FR"></country></address><ref type="url">http://www.cricm.upmc.fr/</ref></desc><listRelation><relation active="#struct-93591" type="direct"></relation><relation name="U975" active="#struct-300002" type="direct"></relation><relation name="UMR7225" active="#struct-441569" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-93591" type="direct"><org type="institution" xml:id="struct-93591" status="VALID"><orgName>Université Pierre et Marie Curie - Paris 6</orgName><orgName type="acronym">UPMC</orgName><desc><address><addrLine>4 place Jussieu - 75005 Paris</addrLine><country key="FR"></country></address><ref type="url">http://www.upmc.fr/</ref></desc></org></tutelle><tutelle name="U975" active="#struct-300002" type="direct"><org type="institution" xml:id="struct-300002" status="VALID"><orgName>INSERM</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle><tutelle name="UMR7225" active="#struct-441569" type="direct"><org type="institution" xml:id="struct-441569" status="VALID"><idno type="IdRef">02636817X</idno><idno type="ISNI">0000000122597504</idno><orgName>Centre National de la Recherche Scientifique</orgName><orgName type="acronym">CNRS</orgName><date type="start">1939-10-19</date><desc><address><country key="FR"></country></address><ref type="url">http://www.cnrs.fr/</ref></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-43171" status="VALID"><orgName>Fédération des Maladies du Système Nerveux</orgName><desc><address><addrLine>47-83, boulevard de l'Hôpital - 75651 PARIS Cedex 13</addrLine><country key="FR"></country></address></desc><listRelation><relation active="#struct-300068" type="direct"></relation><relation active="#struct-300887" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-300068" type="direct"><org type="institution" xml:id="struct-300068" status="VALID"><orgName>Assistance publique - Hôpitaux de Paris (AP-HP)</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle><tutelle active="#struct-300887" type="direct"><org type="institution" xml:id="struct-300887" status="INCOMING"><orgName>Hôpital Pitié-Salpêtrière</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author></analytic><idno type="DOI">10.1002/mds.21949</idno><series><title level="j">Movement Disorders</title><idno type="ISSN">0885-3185</idno><imprint><date type="datePub">2008-05-15</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To evaluate the effects of the dopamine D2-D3 agonist ropinirole in patients who developed apathy after complete withdrawal from dopaminergic medication following successful subthalamic nucleus (STN) stimulation for advanced Parkinson disease (PD). We assessed apathy (Apathy Scale, Apathy Inventory), mood (Montgomery-Asberg Depression Rating Scale), cognitive functions (Mattis Dementia rating scale, frontal score, executive tests) and motor state (UPDRS-III) in 8 PD patients treated with STN stimulation without dopaminergic treatment and who became apathetic. Assessments were made at baseline and after 6 weeks of ropinirole treatment (7.2 +/- 5.9 mg/d; range 1-18 mg/d). Apathy improved with ropinirole in all but 1 patient (54 +/- 24%; range 0-78%). Mood also improved (75 +/- 31%; range 0-100%), but not in correlation with the change in apathy. Cognitive performance was not modified. Stimulation contacts were located within the STN in all patients except the one who remained apathetic in spite of ropinirole treatment (zona incerta). We suggest that apathy, which was compensated for by an enhancement of D2-D3 receptor stimulation in PD patients with STN stimulation: (1) depends on a dopaminergic deficit in associativo-limbic areas of the brain and (2) can be avoided if a dopaminergic agonist is administered postoperatively.</div></front></TEI></HAL><ISTEX><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Apathy following subthalamic stimulation in Parkinson disease: A dopamine responsive symptom</title><author><name sortKey="Czernecki, Virginie" sort="Czernecki, Virginie" uniqKey="Czernecki V" first="Virginie" last="Czernecki">Virginie Czernecki</name></author><author><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name></author><author><name sortKey="Yaici, Sadek" sort="Yaici, Sadek" uniqKey="Yaici S" first="Sadek" last="Yaici">Sadek Yaici</name></author><author><name sortKey="Levy, Richard" sort="Levy, Richard" uniqKey="Levy R" first="Richard" last="Lévy">Richard Lévy</name></author><author><name sortKey="Bardinet, Eric" sort="Bardinet, Eric" uniqKey="Bardinet E" first="Eric" last="Bardinet">Eric Bardinet</name></author><author><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérôme" last="Yelnik">Jérôme Yelnik</name></author><author><name sortKey="Dubois, Bruno" sort="Dubois, Bruno" uniqKey="Dubois B" first="Bruno" last="Dubois">Bruno Dubois</name></author><author><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><affiliation><country>France</country><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:ED91C023356D1D4FFF7501D9DD48101CF35B1793</idno><date when="2008" year="2008">2008</date><idno type="doi">10.1002/mds.21949</idno><idno type="url">https://api.istex.fr/document/ED91C023356D1D4FFF7501D9DD48101CF35B1793/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001B36</idno><idno type="wicri:Area/Istex/Curation">001B36</idno><idno type="wicri:Area/Istex/Checkpoint">001557</idno><idno type="wicri:doubleKey">0885-3185:2008:Czernecki V:apathy:following:subthalamic</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Apathy following subthalamic stimulation in Parkinson disease: A dopamine responsive symptom</title><author><name sortKey="Czernecki, Virginie" sort="Czernecki, Virginie" uniqKey="Czernecki V" first="Virginie" last="Czernecki">Virginie Czernecki</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>INSERM Unit 610, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Neurology, University Hospital, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Yaici, Sadek" sort="Yaici, Sadek" uniqKey="Yaici S" first="Sadek" last="Yaici">Sadek Yaici</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Levy, Richard" sort="Levy, Richard" uniqKey="Levy R" first="Richard" last="Lévy">Richard Lévy</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>INSERM Unit 610, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bardinet, Eric" sort="Bardinet, Eric" uniqKey="Bardinet E" first="Eric" last="Bardinet">Eric Bardinet</name><affiliation wicri:level="4"><country xml:lang="fr">France</country><wicri:regionArea>CNRS‐UPR640, CHU Pitié‐Salpêtrière, Université Pierre et Marie Curie‐Paris 6, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName></affiliation></author><author><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérôme" last="Yelnik">Jérôme Yelnik</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Dubois, Bruno" sort="Dubois, Bruno" uniqKey="Dubois B" first="Bruno" last="Dubois">Bruno Dubois</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>INSERM Unit 610, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. 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>Hoboken</pubPlace><date type="published" when="2008-05-15">2008-05-15</date><biblScope unit="vol">23</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="964">964</biblScope><biblScope unit="page" to="969">969</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">ED91C023356D1D4FFF7501D9DD48101CF35B1793</idno><idno type="DOI">10.1002/mds.21949</idno><idno type="ArticleID">MDS21949</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson disease</term><term>apathy</term><term>dopaminergic agonist</term><term>subthalamic stimulation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To evaluate the effects of the dopamine D2‐D3 agonist ropinirole in patients who developed apathy after complete withdrawal from dopaminergic medication following successful subthalamic nucleus (STN) stimulation for advanced Parkinson disease (PD). We assessed apathy (Apathy Scale, Apathy Inventory), mood (Montgomery‐Åsberg Depression Rating Scale), cognitive functions (Mattis Dementia rating scale, frontal score, executive tests) and motor state (UPDRS‐III) in 8 PD patients treated with STN stimulation without dopaminergic treatment and who became apathetic. Assessments were made at baseline and after 6 weeks of ropinirole treatment (7.2 ± 5.9 mg/d; range 1–18 mg/d). Apathy improved with ropinirole in all but 1 patient (54 ± 24%; range 0–78%). Mood also improved (75 ± 31%; range 0–100%), but not in correlation with the change in apathy. Cognitive performance was not modified. Stimulation contacts were located within the STN in all patients except the one who remained apathetic in spite of ropinirole treatment (zona incerta). We suggest that apathy, which was compensated for by an enhancement of D2‐D3 receptor stimulation in PD patients with STN stimulation: (1) depends on a dopaminergic deficit in associativo‐limbic areas of the brain and (2) can be avoided if a dopaminergic agonist is administered postoperatively. © 2008 Movement Disorder Society</div></front></TEI></ISTEX><PubMed><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Apathy following subthalamic stimulation in Parkinson disease: a dopamine responsive symptom.</title><author><name sortKey="Czernecki, Virginie" sort="Czernecki, Virginie" uniqKey="Czernecki V" first="Virginie" last="Czernecki">Virginie Czernecki</name><affiliation wicri:level="1"><nlm:affiliation>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679, Paris, France. czerneck@chups.jussieu.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name></author><author><name sortKey="Yaici, Sadek" sort="Yaici, Sadek" uniqKey="Yaici S" first="Sadek" last="Yaici">Sadek Yaici</name></author><author><name sortKey="Levy, Richard" sort="Levy, Richard" uniqKey="Levy R" first="Richard" last="Lévy">Richard Lévy</name></author><author><name sortKey="Bardinet, Eric" sort="Bardinet, Eric" uniqKey="Bardinet E" first="Eric" last="Bardinet">Eric Bardinet</name></author><author><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérôme" last="Yelnik">Jérôme Yelnik</name></author><author><name sortKey="Dubois, Bruno" sort="Dubois, Bruno" uniqKey="Dubois B" first="Bruno" last="Dubois">Bruno Dubois</name></author><author><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><affiliation><country>France</country><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2008">2008</date><idno type="doi">10.1002/mds.21949</idno><idno type="RBID">pubmed:18398913</idno><idno type="pmid">18398913</idno><idno type="wicri:Area/PubMed/Corpus">002263</idno><idno type="wicri:Area/PubMed/Curation">002263</idno><idno type="wicri:Area/PubMed/Checkpoint">002434</idno><idno type="wicri:Area/Ncbi/Merge">002098</idno><idno type="wicri:Area/Ncbi/Curation">002098</idno><idno type="wicri:Area/Ncbi/Checkpoint">002098</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Apathy following subthalamic stimulation in Parkinson disease: a dopamine responsive symptom.</title><author><name sortKey="Czernecki, Virginie" sort="Czernecki, Virginie" uniqKey="Czernecki V" first="Virginie" last="Czernecki">Virginie Czernecki</name><affiliation wicri:level="1"><nlm:affiliation>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679, Paris, France. czerneck@chups.jussieu.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name></author><author><name sortKey="Yaici, Sadek" sort="Yaici, Sadek" uniqKey="Yaici S" first="Sadek" last="Yaici">Sadek Yaici</name></author><author><name sortKey="Levy, Richard" sort="Levy, Richard" uniqKey="Levy R" first="Richard" last="Lévy">Richard Lévy</name></author><author><name sortKey="Bardinet, Eric" sort="Bardinet, Eric" uniqKey="Bardinet E" first="Eric" last="Bardinet">Eric Bardinet</name></author><author><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérôme" last="Yelnik">Jérôme Yelnik</name></author><author><name sortKey="Dubois, Bruno" sort="Dubois, Bruno" uniqKey="Dubois B" first="Bruno" last="Dubois">Bruno Dubois</name></author><author><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><affiliation><country>France</country><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2008" type="published">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Deep Brain Stimulation (adverse effects)</term><term>Dopamine Agonists (therapeutic use)</term><term>Female</term><term>Humans</term><term>Indoles (pharmacology)</term><term>Indoles (therapeutic use)</term><term>Male</term><term>Middle Aged</term><term>Mood Disorders (etiology)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (psychology)</term><term>Receptors, Dopamine D2 (drug effects)</term><term>Receptors, Dopamine D3 (drug effects)</term><term>Subthalamic Nucleus (physiopathology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="drug effects" xml:lang="en"><term>Receptors, Dopamine D2</term><term>Receptors, Dopamine D3</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Indoles</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Dopamine Agonists</term><term>Indoles</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Mood Disorders</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To evaluate the effects of the dopamine D2-D3 agonist ropinirole in patients who developed apathy after complete withdrawal from dopaminergic medication following successful subthalamic nucleus (STN) stimulation for advanced Parkinson disease (PD). We assessed apathy (Apathy Scale, Apathy Inventory), mood (Montgomery-Asberg Depression Rating Scale), cognitive functions (Mattis Dementia rating scale, frontal score, executive tests) and motor state (UPDRS-III) in 8 PD patients treated with STN stimulation without dopaminergic treatment and who became apathetic. Assessments were made at baseline and after 6 weeks of ropinirole treatment (7.2 +/- 5.9 mg/d; range 1-18 mg/d). Apathy improved with ropinirole in all but 1 patient (54 +/- 24%; range 0-78%). Mood also improved (75 +/- 31%; range 0-100%), but not in correlation with the change in apathy. Cognitive performance was not modified. Stimulation contacts were located within the STN in all patients except the one who remained apathetic in spite of ropinirole treatment (zona incerta). We suggest that apathy, which was compensated for by an enhancement of D2-D3 receptor stimulation in PD patients with STN stimulation: (1) depends on a dopaminergic deficit in associativo-limbic areas of the brain and (2) can be avoided if a dopaminergic agonist is administered postoperatively.</div></front></TEI></PubMed></double></record>Pour manipuler ce document sous Unix (Dilib)
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