Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease
Identifieur interne : 002484 ( Istex/Corpus ); précédent : 002483; suivant : 002485Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease
Auteurs : A. Funkiewiez ; C. Ardouin ; E. Caputo ; P. Krack ; V. Fraix ; H. Klinger ; S. Chabardes ; K. Foote ; A-L Benabid ; P. PollakSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2004-06.
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- KwdEn :
Abstract
Background: Long term effects of subthalamic nucleus (STN) stimulation on cognition, mood, and behaviour are unknown. Objective: This study evaluated the cognitive, mood, and behavioural effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with Parkinson’s disease (PD) followed up for three years. Methods: A consecutive series of 77 PD patients was assessed before, one, and three years after surgery. Mean (SD) age at surgery was 55 (8). Seven patients died or were lost for follow up. Neuropsychological assessment included a global cognitive scale, memory, and frontal tests. Depression was evaluated using the Beck depression inventory. Assessment of thought disorders and apathy was based on the unified Parkinson’s disease rating scale. Reports of the behavioural changes are mainly based on interviews done by the same neuropsychologist at each follow up. Results: Only two cognitive variables worsened (category fluency, total score of fluency). Age was a predictor of decline in executive functions. Depression improved whereas apathy and thought disorders worsened. Major behavioural changes were two transient aggressive impulsive episodes, one suicide, four suicide attempts, one permanent apathy, one transient severe depression, four psychoses (one permanent), and five hypomania (one permanent). Conclusions: Comparing baseline, one year, and three year postoperative assessments, STN stimulation did not lead to global cognitive deterioration. Apathy scores mildly increased. Depression scores mildly improved. Behavioural changes were comparatively rare and mostly transient. Single case reports show the major synergistic effects of both medication and stimulation on mood and behaviour, illustrating the importance of a correct postoperative management.
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DOI: 10.1136/jnnp.2002.009803
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease</title><author><name sortKey="Funkiewiez, A" sort="Funkiewiez, A" uniqKey="Funkiewiez A" first="A" last="Funkiewiez">A. Funkiewiez</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C" last="Ardouin">C. Ardouin</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Caputo, E" sort="Caputo, E" uniqKey="Caputo E" first="E" last="Caputo">E. Caputo</name><affiliation><mods:affiliation>Department of Neurology, Ospedale San Paolo, Milan, Italy</mods:affiliation></affiliation></author><author><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P" last="Krack">P. Krack</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V" last="Fraix">V. Fraix</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Klinger, H" sort="Klinger, H" uniqKey="Klinger H" first="H" last="Klinger">H. Klinger</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Chabardes, S" sort="Chabardes, S" uniqKey="Chabardes S" first="S" last="Chabardes">S. Chabardes</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Foote, K" sort="Foote, K" uniqKey="Foote K" first="K" last="Foote">K. Foote</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A-L" last="Benabid">A-L Benabid</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P" last="Pollak">P. 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Funkiewiez</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C" last="Ardouin">C. Ardouin</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Caputo, E" sort="Caputo, E" uniqKey="Caputo E" first="E" last="Caputo">E. Caputo</name><affiliation><mods:affiliation>Department of Neurology, Ospedale San Paolo, Milan, Italy</mods:affiliation></affiliation></author><author><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P" last="Krack">P. Krack</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V" last="Fraix">V. Fraix</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Klinger, H" sort="Klinger, H" uniqKey="Klinger H" first="H" last="Klinger">H. Klinger</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Chabardes, S" sort="Chabardes, S" uniqKey="Chabardes S" first="S" last="Chabardes">S. Chabardes</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Foote, K" sort="Foote, K" uniqKey="Foote K" first="K" last="Foote">K. Foote</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A-L" last="Benabid">A-L Benabid</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P" last="Pollak">P. Pollak</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2004-06">2004-06</date><biblScope unit="volume">75</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="834">834</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">A8F47CC6437D8D68F7D5A02679410056F32FDD1F</idno><idno type="DOI">10.1136/jnnp.2002.009803</idno><idno type="href">jnnp-75-834.pdf</idno><idno type="PMID">15145995</idno><idno type="local">0750834</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>BDI, Beck depression inventory</term><term>MDRS, Mattis dementia rating scale</term><term>PD, Parkinson’s disease</term><term>Parkinson’s disease</term><term>STN DBS, subthalamic deep brain stimulation</term><term>STN stimulation</term><term>UPDRS, unified Parkinson’s disease rating scale</term><term>WCST, Wisconsin card sorting test</term><term>cognition</term><term>mood</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Long term effects of subthalamic nucleus (STN) stimulation on cognition, mood, and behaviour are unknown. Objective: This study evaluated the cognitive, mood, and behavioural effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with Parkinson’s disease (PD) followed up for three years. Methods: A consecutive series of 77 PD patients was assessed before, one, and three years after surgery. Mean (SD) age at surgery was 55 (8). Seven patients died or were lost for follow up. Neuropsychological assessment included a global cognitive scale, memory, and frontal tests. Depression was evaluated using the Beck depression inventory. Assessment of thought disorders and apathy was based on the unified Parkinson’s disease rating scale. Reports of the behavioural changes are mainly based on interviews done by the same neuropsychologist at each follow up. Results: Only two cognitive variables worsened (category fluency, total score of fluency). Age was a predictor of decline in executive functions. Depression improved whereas apathy and thought disorders worsened. Major behavioural changes were two transient aggressive impulsive episodes, one suicide, four suicide attempts, one permanent apathy, one transient severe depression, four psychoses (one permanent), and five hypomania (one permanent). Conclusions: Comparing baseline, one year, and three year postoperative assessments, STN stimulation did not lead to global cognitive deterioration. Apathy scores mildly increased. Depression scores mildly improved. Behavioural changes were comparatively rare and mostly transient. Single case reports show the major synergistic effects of both medication and stimulation on mood and behaviour, illustrating the importance of a correct postoperative management.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>A Funkiewiez</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>C Ardouin</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>E Caputo</name><affiliations><json:string>Department of Neurology, Ospedale San Paolo, Milan, Italy</json:string></affiliations></json:item><json:item><name>P Krack</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>V Fraix</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>H Klinger</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>S Chabardes</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>K Foote</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>A-L Benabid</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>P Pollak</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Stroke</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Mood disorders (including depression)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Psychotic disorders (incl schizophrenia)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Suicide (psychiatry)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cognition</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>mood</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson’s disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>STN stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>STN DBS, subthalamic deep brain stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PD, Parkinson’s disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>WCST, Wisconsin card sorting test</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MDRS, Mattis dementia rating scale</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>BDI, Beck depression inventory</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>UPDRS, unified Parkinson’s disease rating scale</value></json:item></subject><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background: Long term effects of subthalamic nucleus (STN) stimulation on cognition, mood, and behaviour are unknown. Objective: This study evaluated the cognitive, mood, and behavioural effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with Parkinson’s disease (PD) followed up for three years. Methods: A consecutive series of 77 PD patients was assessed before, one, and three years after surgery. Mean (SD) age at surgery was 55 (8). Seven patients died or were lost for follow up. Neuropsychological assessment included a global cognitive scale, memory, and frontal tests. Depression was evaluated using the Beck depression inventory. Assessment of thought disorders and apathy was based on the unified Parkinson’s disease rating scale. Reports of the behavioural changes are mainly based on interviews done by the same neuropsychologist at each follow up. Results: Only two cognitive variables worsened (category fluency, total score of fluency). Age was a predictor of decline in executive functions. Depression improved whereas apathy and thought disorders worsened. Major behavioural changes were two transient aggressive impulsive episodes, one suicide, four suicide attempts, one permanent apathy, one transient severe depression, four psychoses (one permanent), and five hypomania (one permanent). Conclusions: Comparing baseline, one year, and three year postoperative assessments, STN stimulation did not lead to global cognitive deterioration. Apathy scores mildly increased. Depression scores mildly improved. Behavioural changes were comparatively rare and mostly transient. Single case reports show the major synergistic effects of both medication and stimulation on mood and behaviour, illustrating the importance of a correct postoperative management.</abstract><qualityIndicators><score>10</score><pdfVersion>1.2</pdfVersion><pdfPageSize>609.08 x 790.583 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>14</keywordCount><abstractCharCount>1807</abstractCharCount><pdfWordCount>5298</pdfWordCount><pdfCharCount>35004</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>252</abstractWordCount></qualityIndicators><title>Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease</title><pmid><json:string>15145995</json:string></pmid><refBibs><json:item><host><volume>339</volume><pages><first>1105</first></pages><author></author><title>N Engl J Med</title></host></json:item><json:item><host><volume>345</volume><pages><first>956</first></pages><author></author><title>N 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Neurosci</title></host></json:item></refBibs><genre><json:string>research-article</json:string></genre><host><volume>75</volume><pages><first>834</first></pages><issn><json:string>0022-3050</json:string></issn><issue>6</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><categories><wos><json:string>social science</json:string><json:string>psychiatry</json:string><json:string>science</json:string><json:string>surgery</json:string><json:string>clinical neurology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>neurology & neurosurgery</json:string></scienceMetrix></categories><publicationDate>2004</publicationDate><copyrightDate>2004</copyrightDate><doi><json:string>10.1136/jnnp.2002.009803</json:string></doi><id>A8F47CC6437D8D68F7D5A02679410056F32FDD1F</id><score>0.26905262</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/A8F47CC6437D8D68F7D5A02679410056F32FDD1F/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/A8F47CC6437D8D68F7D5A02679410056F32FDD1F/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/A8F47CC6437D8D68F7D5A02679410056F32FDD1F/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>Copyright 2004 Journal of Neurology Neurosurgery and Psychiatry</p></availability><date>2004-05-14</date></publicationStmt><notesStmt><note>Correspondence to:
Dr P Krack
Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, BP 217, 38043 Grenoble Cedex 9, France; paul.krack@ujf-grenoble.fr</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease</title><author xml:id="author-1"><persName><forename type="first">A</forename><surname>Funkiewiez</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation></author><author xml:id="author-2"><persName><forename type="first">C</forename><surname>Ardouin</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation></author><author xml:id="author-3"><persName><forename type="first">E</forename><surname>Caputo</surname></persName><affiliation>Department of Neurology, Ospedale San Paolo, Milan, Italy</affiliation></author><author xml:id="author-4"><persName><forename type="first">P</forename><surname>Krack</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation></author><author xml:id="author-5"><persName><forename type="first">V</forename><surname>Fraix</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation></author><author xml:id="author-6"><persName><forename type="first">H</forename><surname>Klinger</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation></author><author xml:id="author-7"><persName><forename type="first">S</forename><surname>Chabardes</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation></author><author xml:id="author-8"><persName><forename type="first">K</forename><surname>Foote</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation></author><author xml:id="author-9"><persName><forename type="first">A-L</forename><surname>Benabid</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation></author><author xml:id="author-10"><persName><forename type="first">P</forename><surname>Pollak</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2004-06"></date><biblScope unit="volume">75</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="834">834</biblScope></imprint></monogr><idno type="istex">A8F47CC6437D8D68F7D5A02679410056F32FDD1F</idno><idno type="DOI">10.1136/jnnp.2002.009803</idno><idno type="href">jnnp-75-834.pdf</idno><idno type="PMID">15145995</idno><idno type="local">0750834</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2004-05-14</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background: Long term effects of subthalamic nucleus (STN) stimulation on cognition, mood, and behaviour are unknown. Objective: This study evaluated the cognitive, mood, and behavioural effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with Parkinson’s disease (PD) followed up for three years. Methods: A consecutive series of 77 PD patients was assessed before, one, and three years after surgery. Mean (SD) age at surgery was 55 (8). Seven patients died or were lost for follow up. Neuropsychological assessment included a global cognitive scale, memory, and frontal tests. Depression was evaluated using the Beck depression inventory. Assessment of thought disorders and apathy was based on the unified Parkinson’s disease rating scale. Reports of the behavioural changes are mainly based on interviews done by the same neuropsychologist at each follow up. Results: Only two cognitive variables worsened (category fluency, total score of fluency). Age was a predictor of decline in executive functions. Depression improved whereas apathy and thought disorders worsened. Major behavioural changes were two transient aggressive impulsive episodes, one suicide, four suicide attempts, one permanent apathy, one transient severe depression, four psychoses (one permanent), and five hypomania (one permanent). Conclusions: Comparing baseline, one year, and three year postoperative assessments, STN stimulation did not lead to global cognitive deterioration. Apathy scores mildly increased. Depression scores mildly improved. Behavioural changes were comparatively rare and mostly transient. Single case reports show the major synergistic effects of both medication and stimulation on mood and behaviour, illustrating the importance of a correct postoperative management.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Stroke</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Mood disorders (including depression)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Psychotic disorders (incl schizophrenia)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Suicide (psychiatry)</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>KWD</head><item><term>cognition</term></item><item><term>mood</term></item><item><term>Parkinson’s disease</term></item><item><term>STN stimulation</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>ABR</head><item><term>STN DBS, subthalamic deep brain stimulation</term></item><item><term>PD, Parkinson’s disease</term></item><item><term>WCST, Wisconsin card sorting test</term></item><item><term>MDRS, Mattis dementia rating scale</term></item><item><term>BDI, Beck depression inventory</term></item><item><term>UPDRS, unified Parkinson’s disease rating scale</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2004-05-14">Created</change><change when="2004-06">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/A8F47CC6437D8D68F7D5A02679410056F32FDD1F/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">0750834</article-id><article-id pub-id-type="doi">10.1136/jnnp.2002.009803</article-id><article-id pub-id-type="other">jnnp;75/6/834</article-id><article-id pub-id-type="pmid">15145995</article-id><article-id pub-id-type="other">834</article-id><article-id pub-id-type="other">jnnp.2002.009803</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Papers</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Stroke</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Mood disorders (including depression)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Psychotic disorders (incl schizophrenia)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Suicide (psychiatry)</subject></subj-group></article-categories><title-group><article-title>Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Funkiewiez</surname><given-names>A</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Ardouin</surname><given-names>C</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Caputo</surname><given-names>E</given-names></name><xref rid="AFF2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Krack</surname><given-names>P</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Fraix</surname><given-names>V</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Klinger</surname><given-names>H</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Chabardes</surname><given-names>S</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Foote</surname><given-names>K</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Benabid</surname><given-names>A-L</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Pollak</surname><given-names>P</given-names></name><xref rid="AFF1">1</xref></contrib><aff id="AFF1"><label>1</label>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</aff><aff id="AFF2"><label>2</label>Department of Neurology, Ospedale San Paolo, Milan, Italy</aff></contrib-group><author-notes><corresp>Correspondence to:
Dr P Krack
Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, BP 217, 38043 Grenoble Cedex 9, France; <ext-link xlink:href="paul.krackujf-grenoble.fr" ext-link-type="email" xlink:type="simple">paul.krack@ujf-grenoble.fr</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2004</year></pub-date><pub-date pub-type="epub"><day>14</day><month>5</month><year>2004</year></pub-date><volume>75</volume><volume-id pub-id-type="other">75</volume-id><volume-id pub-id-type="other">75</volume-id><issue>6</issue><issue-id pub-id-type="other">jnnp;75/6</issue-id><issue-id pub-id-type="other">6</issue-id><issue-id pub-id-type="other">75/6</issue-id><fpage>834</fpage><history><date date-type="accepted"><day>23</day><month>08</month><year>2003</year></date><date date-type="received"><day>26</day><month>12</month><year>2002</year></date><date date-type="rev-recd"><day>25</day><month>07</month><year>2003</year></date></history><permissions><copyright-statement>Copyright 2004 Journal of Neurology Neurosurgery and Psychiatry</copyright-statement><copyright-year>2004</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-75-834.pdf"></self-uri><abstract xml:lang="en"><p><bold>Background:</bold> Long term effects of subthalamic nucleus (STN) stimulation on cognition, mood, and behaviour are unknown.</p><p><bold>Objective:</bold> This study evaluated the cognitive, mood, and behavioural effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with Parkinson’s disease (PD) followed up for three years.</p><p><bold>Methods:</bold> A consecutive series of 77 PD patients was assessed before, one, and three years after surgery. Mean (SD) age at surgery was 55 (8). Seven patients died or were lost for follow up. Neuropsychological assessment included a global cognitive scale, memory, and frontal tests. Depression was evaluated using the Beck depression inventory. Assessment of thought disorders and apathy was based on the unified Parkinson’s disease rating scale. Reports of the behavioural changes are mainly based on interviews done by the same neuropsychologist at each follow up.</p><p><bold>Results:</bold> Only two cognitive variables worsened (category fluency, total score of fluency). Age was a predictor of decline in executive functions. Depression improved whereas apathy and thought disorders worsened. Major behavioural changes were two transient aggressive impulsive episodes, one suicide, four suicide attempts, one permanent apathy, one transient severe depression, four psychoses (one permanent), and five hypomania (one permanent).</p><p><bold>Conclusions:</bold> Comparing baseline, one year, and three year postoperative assessments, STN stimulation did not lead to global cognitive deterioration. Apathy scores mildly increased. Depression scores mildly improved. Behavioural changes were comparatively rare and mostly transient. Single case reports show the major synergistic effects of both medication and stimulation on mood and behaviour, illustrating the importance of a correct postoperative management.</p></abstract><kwd-group kwd-group-type="KWD" xml:lang="en"><kwd>cognition</kwd><kwd>mood</kwd><kwd>Parkinson’s disease</kwd><kwd>STN stimulation</kwd></kwd-group><kwd-group kwd-group-type="ABR" xml:lang="en"><kwd>STN DBS, subthalamic deep brain stimulation</kwd><kwd>PD, Parkinson’s disease</kwd><kwd>WCST, Wisconsin card sorting test</kwd><kwd>MDRS, Mattis dementia rating scale</kwd><kwd>BDI, Beck depression inventory</kwd><kwd>UPDRS, unified Parkinson’s disease rating scale</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease</title></titleInfo><name type="personal"><namePart type="given">A</namePart><namePart type="family">Funkiewiez</namePart><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C</namePart><namePart type="family">Ardouin</namePart><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E</namePart><namePart type="family">Caputo</namePart><affiliation>Department of Neurology, Ospedale San Paolo, Milan, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P</namePart><namePart type="family">Krack</namePart><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">V</namePart><namePart type="family">Fraix</namePart><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H</namePart><namePart type="family">Klinger</namePart><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S</namePart><namePart type="family">Chabardes</namePart><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K</namePart><namePart type="family">Foote</namePart><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A-L</namePart><namePart type="family">Benabid</namePart><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P</namePart><namePart type="family">Pollak</namePart><affiliation>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Stroke</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Mood disorders (including depression)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Psychotic disorders (incl schizophrenia)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Suicide (psychiatry)</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2004-06</dateIssued><dateCreated encoding="w3cdtf">2004-05-14</dateCreated><copyrightDate encoding="w3cdtf">2004</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Background: Long term effects of subthalamic nucleus (STN) stimulation on cognition, mood, and behaviour are unknown. Objective: This study evaluated the cognitive, mood, and behavioural effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with Parkinson’s disease (PD) followed up for three years. Methods: A consecutive series of 77 PD patients was assessed before, one, and three years after surgery. Mean (SD) age at surgery was 55 (8). Seven patients died or were lost for follow up. Neuropsychological assessment included a global cognitive scale, memory, and frontal tests. Depression was evaluated using the Beck depression inventory. Assessment of thought disorders and apathy was based on the unified Parkinson’s disease rating scale. Reports of the behavioural changes are mainly based on interviews done by the same neuropsychologist at each follow up. Results: Only two cognitive variables worsened (category fluency, total score of fluency). Age was a predictor of decline in executive functions. Depression improved whereas apathy and thought disorders worsened. Major behavioural changes were two transient aggressive impulsive episodes, one suicide, four suicide attempts, one permanent apathy, one transient severe depression, four psychoses (one permanent), and five hypomania (one permanent). Conclusions: Comparing baseline, one year, and three year postoperative assessments, STN stimulation did not lead to global cognitive deterioration. Apathy scores mildly increased. Depression scores mildly improved. Behavioural changes were comparatively rare and mostly transient. Single case reports show the major synergistic effects of both medication and stimulation on mood and behaviour, illustrating the importance of a correct postoperative management.</abstract><note type="author-notes">Correspondence to:
Dr P Krack
Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, BP 217, 38043 Grenoble Cedex 9, France; paul.krack@ujf-grenoble.fr</note><subject lang="en"><genre>KWD</genre><topic>cognition</topic><topic>mood</topic><topic>Parkinson’s disease</topic><topic>STN stimulation</topic></subject><subject lang="en"><genre>ABR</genre><topic>STN DBS, subthalamic deep brain stimulation</topic><topic>PD, Parkinson’s disease</topic><topic>WCST, Wisconsin card sorting test</topic><topic>MDRS, Mattis dementia rating scale</topic><topic>BDI, Beck depression inventory</topic><topic>UPDRS, unified Parkinson’s disease rating scale</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2004</date><detail type="volume"><caption>vol.</caption><number>75</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>834</start></extent></part></relatedItem><identifier type="istex">A8F47CC6437D8D68F7D5A02679410056F32FDD1F</identifier><identifier type="DOI">10.1136/jnnp.2002.009803</identifier><identifier type="href">jnnp-75-834.pdf</identifier><identifier type="PMID">15145995</identifier><identifier type="local">0750834</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright 2004 Journal of Neurology Neurosurgery and Psychiatry</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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