Behavioural disorders, Parkinson's disease and subthalamic stimulation
Identifieur interne : 003393 ( Main/Exploration ); précédent : 003392; suivant : 003394Behavioural disorders, Parkinson's disease and subthalamic stimulation
Auteurs : J L Houeto [France] ; V. Mesnage [France] ; L. Mallet [France] ; B. Pillon [France] ; M. Gargiulo [France] ; S Tezenas Du Moncel [France] ; A M Bonnet [France] ; B. Pidoux [France] ; D. Dormont [France] ; P. Cornu [France] ; Yves Agid [France]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2002-06.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Anxiety (etiology), Behavioral disorder, Bilateral, Complication, Depression (etiology), Electric Stimulation Therapy (adverse effects), Female, Frequency, Human, Humans, ISPC, IOWA scales of personality change, Instrumental stimulation, MINI, mini international neuropsychiatric inventory, Male, Mental Status Schedule, Middle Aged, Motor Skills Disorders (etiology), Motor Skills Disorders (therapy), Parkinson Disease (pathology), Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Personality, Quality of Life, SAS, social adjustment scale, STN, subthalamic nucleus, Social Behavior, Substance-Related Disorders, Subthalamic Nucleus (physiology), Subthalamic nucleus, Treatment Outcome, UPDRS, unified Parkinson's disease rating scale, behavioural disorders, high frequency stimulation, psychiatry, subthalamic nucleus.
- MESH :
- adverse effects : Electric Stimulation Therapy.
- etiology : Anxiety, Depression, Motor Skills Disorders.
- pathology : Parkinson Disease.
- physiology : Subthalamic Nucleus.
- therapy : Motor Skills Disorders, Parkinson Disease.
- Female, Humans, Male, Mental Status Schedule, Middle Aged, Personality, Quality of Life, Social Behavior, Substance-Related Disorders, Treatment Outcome.
Abstract
Objective: to analyse 24 parkinsonian patients successfully treated by bilateral STN stimulation for the presence of behavioural disorders. Method: patients were evaluated retrospectively for adjustment disorders (social adjustment scale, SAS), psychiatric disorders (comparison of the results of psychiatric interview and the mini international neuropsychiatric inventory) and personality changes (IOWA scale of personality changes). Results: parkinsonian motor disability was improved by 69.5% and the levodopa equivalent daily dosage was reduced by 60.5%. Social adjustment (SAS) was considered good or excellent in nine patients, moderately (n=14), or severely (n=1) impaired in 15 patients. Psychiatric disorders consisted of amplification or decompensation of previously existing disorders that had sometimes passed unnoticed, such as depressive episodes (n=4), generalised anxiety (n=18), and behavioural disorders with drug dependence (n=2). Appearance of mild to moderate emotional hyperreactivity was reported in 15 patients. Personality traits (IOWA scale) were improved in eight patients, unchanged in seven, and aggravated in eight Conclusion: Improvement in parkinsonian motor disability induced by STN stimulation is not necessarily accompanied by improvement in psychic function and quality of life. Attention is drawn to the possible appearance of personality disorders and decompensation of previous psychiatric disorders in parkinsonian patients who are suitable candidates for neurosurgery. We suggest that a careful psychological and psychiatric interview be performed before surgery, and emphasise the need for psychological follow up to ensure the best possible outcome.
Url:
- https://api.istex.fr/document/176B41D8319AC2E36282D9C5568DEA05FC0C4088/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1737905
DOI: 10.1136/jnnp.72.6.701
Affiliations:
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anxiety (etiology)</term>
<term>Behavioral disorder</term>
<term>Bilateral</term>
<term>Complication</term>
<term>Depression (etiology)</term>
<term>Electric Stimulation Therapy (adverse effects)</term>
<term>Female</term>
<term>Frequency</term>
<term>Human</term>
<term>Humans</term>
<term>ISPC, IOWA scales of personality change</term>
<term>Instrumental stimulation</term>
<term>MINI, mini international neuropsychiatric inventory</term>
<term>Male</term>
<term>Mental Status Schedule</term>
<term>Middle Aged</term>
<term>Motor Skills Disorders (etiology)</term>
<term>Motor Skills Disorders (therapy)</term>
<term>Parkinson Disease (pathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Parkinson disease</term>
<term>Parkinson's disease</term>
<term>Personality</term>
<term>Quality of Life</term>
<term>SAS, social adjustment scale</term>
<term>STN, subthalamic nucleus</term>
<term>Social Behavior</term>
<term>Substance-Related Disorders</term>
<term>Subthalamic Nucleus (physiology)</term>
<term>Subthalamic nucleus</term>
<term>Treatment Outcome</term>
<term>UPDRS, unified Parkinson's disease rating scale</term>
<term>behavioural disorders</term>
<term>high frequency stimulation</term>
<term>psychiatry</term>
<term>subthalamic nucleus</term>
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<term>Motor Skills Disorders</term>
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<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Subthalamic Nucleus</term>
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<term>Parkinson Disease</term>
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<keywords scheme="MESH" xml:lang="en"><term>Female</term>
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<term>Male</term>
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<term>Middle Aged</term>
<term>Personality</term>
<term>Quality of Life</term>
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<term>Substance-Related Disorders</term>
<term>Treatment Outcome</term>
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<term>Complication</term>
<term>Fréquence</term>
<term>Homme</term>
<term>Noyau sousthalamique</term>
<term>Parkinson maladie</term>
<term>Stimulation instrumentale</term>
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<front><div type="abstract" xml:lang="en">Objective: to analyse 24 parkinsonian patients successfully treated by bilateral STN stimulation for the presence of behavioural disorders. Method: patients were evaluated retrospectively for adjustment disorders (social adjustment scale, SAS), psychiatric disorders (comparison of the results of psychiatric interview and the mini international neuropsychiatric inventory) and personality changes (IOWA scale of personality changes). Results: parkinsonian motor disability was improved by 69.5% and the levodopa equivalent daily dosage was reduced by 60.5%. Social adjustment (SAS) was considered good or excellent in nine patients, moderately (n=14), or severely (n=1) impaired in 15 patients. Psychiatric disorders consisted of amplification or decompensation of previously existing disorders that had sometimes passed unnoticed, such as depressive episodes (n=4), generalised anxiety (n=18), and behavioural disorders with drug dependence (n=2). Appearance of mild to moderate emotional hyperreactivity was reported in 15 patients. Personality traits (IOWA scale) were improved in eight patients, unchanged in seven, and aggravated in eight Conclusion: Improvement in parkinsonian motor disability induced by STN stimulation is not necessarily accompanied by improvement in psychic function and quality of life. Attention is drawn to the possible appearance of personality disorders and decompensation of previous psychiatric disorders in parkinsonian patients who are suitable candidates for neurosurgery. We suggest that a careful psychological and psychiatric interview be performed before surgery, and emphasise the need for psychological follow up to ensure the best possible outcome.</div>
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