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Movement Disorders (revue)

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

Identifieur interne : 000870 ( PascalFrancis/Curation ); précédent : 000869; suivant : 000871

Acute 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 :

RBID : Pascal:03-0381006

Descripteurs français

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.
pA  
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A03   1    @0 Mov. disord.
A05       @2 18
A06       @2 5
A08 01  1  ENG  @1 Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease
A11 01  1    @1 FUNKIEWIEZ (Aurélie)
A11 02  1    @1 ARDOUIN (Claire)
A11 03  1    @1 KRACK (Paul)
A11 04  1    @1 FRAIX (Valérie)
A11 05  1    @1 VAN BLERCOM (Nadège)
A11 06  1    @1 JING XIE
A11 07  1    @1 MORO (Elena)
A11 08  1    @1 BENABID (Alim-Louis)
A11 09  1    @1 POLLAK (Pierre)
A14 01      @1 Department of Clinical and Biological Neurosciences, Joseph Fourier University @2 Grenoble @3 FRA @Z 1 aut. @Z 2 aut. @Z 3 aut. @Z 4 aut. @Z 5 aut. @Z 6 aut. @Z 7 aut. @Z 8 aut. @Z 9 aut.
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A21       @1 2003
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A47 01  1    @0 03-0381006
A60       @1 P
A61       @0 A
A64 01  1    @0 Movement disorders
A66 01      @0 USA
C01 01    ENG  @0 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.
C02 01  X    @0 002B02B06
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C03 01  X  ENG  @0 Parkinson disease @5 01
C03 01  X  SPA  @0 Parkinson enfermedad @5 01
C03 02  X  FRE  @0 Lévodopa @2 NK @2 FR @5 04
C03 02  X  ENG  @0 Levodopa @2 NK @2 FR @5 04
C03 02  X  SPA  @0 Levodopa @2 NK @2 FR @5 04
C03 03  X  FRE  @0 Antiparkinsonien @5 05
C03 03  X  ENG  @0 Antiparkinson agent @5 05
C03 03  X  SPA  @0 Antiparkinsoniano @5 05
C03 04  X  FRE  @0 Stimulation instrumentale @5 07
C03 04  X  ENG  @0 Instrumental stimulation @5 07
C03 04  X  SPA  @0 Estimulación instrumental @5 07
C03 05  X  FRE  @0 Bilatéral @5 08
C03 05  X  ENG  @0 Bilateral @5 08
C03 05  X  SPA  @0 Bilateral @5 08
C03 06  X  FRE  @0 Noyau sousthalamique @5 09
C03 06  X  ENG  @0 Subthalamic nucleus @5 09
C03 06  X  SPA  @0 Núcleo subtalámico @5 09
C03 07  X  FRE  @0 Humeur @5 10
C03 07  X  ENG  @0 Mood @5 10
C03 07  X  SPA  @0 Humor @5 10
C03 08  X  FRE  @0 Psychotrope @2 FX @5 13
C03 08  X  ENG  @0 Psychotropic @2 FX @5 13
C03 08  X  SPA  @0 Psicotropo @2 FX @5 13
C03 09  X  FRE  @0 Chimiothérapie @5 16
C03 09  X  ENG  @0 Chemotherapy @5 16
C03 09  X  SPA  @0 Quimioterapia @5 16
C03 10  X  FRE  @0 Traitement @5 17
C03 10  X  ENG  @0 Treatment @5 17
C03 10  X  SPA  @0 Tratamiento @5 17
C03 11  X  FRE  @0 Homme @5 20
C03 11  X  ENG  @0 Human @5 20
C03 11  X  SPA  @0 Hombre @5 20
C07 01  X  FRE  @0 Système nerveux pathologie @5 37
C07 01  X  ENG  @0 Nervous system diseases @5 37
C07 01  X  SPA  @0 Sistema nervioso patología @5 37
C07 02  X  FRE  @0 Système nerveux central pathologie @5 38
C07 02  X  ENG  @0 Central nervous system disease @5 38
C07 02  X  SPA  @0 Sistema nervosio central patología @5 38
C07 03  X  FRE  @0 Encéphale pathologie @5 39
C07 03  X  ENG  @0 Cerebral disorder @5 39
C07 03  X  SPA  @0 Encéfalo patología @5 39
C07 04  X  FRE  @0 Extrapyramidal syndrome @5 40
C07 04  X  ENG  @0 Extrapyramidal syndrome @5 40
C07 04  X  SPA  @0 Extrapiramidal síndrome @5 40
C07 05  X  FRE  @0 Maladie dégénérative @5 41
C07 05  X  ENG  @0 Degenerative disease @5 41
C07 05  X  SPA  @0 Enfermedad degenerativa @5 41
C07 06  X  FRE  @0 Traitement instrumental @5 53
C07 06  X  ENG  @0 Instrumentation therapy @5 53
C07 06  X  SPA  @0 Tratamiento instrumental @5 53
N21       @1 265
N82       @1 PSI

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<term>Instrumental stimulation</term>
<term>Levodopa</term>
<term>Mood</term>
<term>Parkinson disease</term>
<term>Psychotropic</term>
<term>Subthalamic nucleus</term>
<term>Treatment</term>
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<term>Parkinson maladie</term>
<term>Lévodopa</term>
<term>Antiparkinsonien</term>
<term>Stimulation instrumentale</term>
<term>Bilatéral</term>
<term>Noyau sousthalamique</term>
<term>Humeur</term>
<term>Psychotrope</term>
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<term>Traitement</term>
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<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.</div>
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