Apathy Following Subthalamic Stimulation in Parkinson Disease : A Dopamine Responsive Symptom
Identifieur interne : 003974 ( Main/Merge ); précédent : 003973; suivant : 003975Apathy Following Subthalamic Stimulation in Parkinson Disease : A Dopamine Responsive Symptom
Auteurs : Virginie Czernecki [France] ; Michael Schüpbach [France, Suisse] ; Sadek Yaici [France] ; Richard Levy [France] ; Eric Bardinet [France] ; Jérome Yelnik [France] ; Bruno Dubois [France] ; Yves Agid [France]Source :
- Movement disorders [ 0885-3185 ] ; 2008.
Descripteurs français
- Pascal (Inist)
English descriptors
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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.
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aut.</sZ></inist:fA14><country>Suisse</country><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"><inist:fA14 i1="01"><s1>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Levy, Richard" sort="Levy, Richard" uniqKey="Levy R" first="Richard" last="Levy">Richard Levy</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>INSERM Unit 610</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><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="1"><inist:fA14 i1="04"><s1>CNRS-UPR640, CHU Pitié-Salpêtrière, Université Pierre et Marie Curie-Paris 6</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérome" last="Yelnik">Jérome Yelnik</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="02"><s1>INSERM Unit 610</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Center d'Investigation Clinique, Fédération de Neurologie, INSERM Unit 679</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><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><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Apathy</term><term>Dopamine</term><term>Nervous system diseases</term><term>Parkinson disease</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Dopamine</term><term>Apathie</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-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.</div></front></TEI><affiliations><list><country><li>France</li><li>Suisse</li></country><region><li>Canton de Berne</li><li>Île-de-France</li></region><settlement><li>Berne</li><li>Paris</li></settlement><orgName><li>Hôpital de la Salpêtrière</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Czernecki, Virginie" sort="Czernecki, Virginie" uniqKey="Czernecki V" first="Virginie" last="Czernecki">Virginie Czernecki</name></noRegion><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name><name sortKey="Bardinet, Eric" sort="Bardinet, Eric" uniqKey="Bardinet E" first="Eric" last="Bardinet">Eric Bardinet</name><name sortKey="Czernecki, Virginie" sort="Czernecki, Virginie" uniqKey="Czernecki V" first="Virginie" last="Czernecki">Virginie Czernecki</name><name sortKey="Dubois, Bruno" sort="Dubois, Bruno" uniqKey="Dubois B" first="Bruno" last="Dubois">Bruno Dubois</name><name sortKey="Levy, Richard" sort="Levy, Richard" uniqKey="Levy R" first="Richard" last="Levy">Richard Levy</name><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name><name sortKey="Yaici, Sadek" sort="Yaici, Sadek" uniqKey="Yaici S" first="Sadek" last="Yaici">Sadek Yaici</name><name sortKey="Yelnik, Jerome" sort="Yelnik, Jerome" uniqKey="Yelnik J" first="Jérome" last="Yelnik">Jérome Yelnik</name></country><country name="Suisse"><region name="Canton de Berne"><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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