Contact dependent reproducible hypomania induced by deep brain stimulation in Parkinson's disease: clinical, anatomical and functional imaging study
Identifieur interne : 001C21 ( Main/Merge ); précédent : 001C20; suivant : 001C22Contact dependent reproducible hypomania induced by deep brain stimulation in Parkinson's disease: clinical, anatomical and functional imaging study
Auteurs : Miguel Ulla [France] ; Stéphane Thobois [France] ; Pierre-Michel Llorca [France] ; Philippe Derost [France] ; Jean-Jacques Lemaire [France] ; Isabelle Chereau-Boudet [France] ; Ingrid De Chazeron [France] ; Audrey Schmitt [France] ; Bénédicte Ballanger [France] ; Emmanuel Broussolle [France] ; Franck Durif [France]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2011-06.
English descriptors
- KwdEn :
- Aged, Attention (physiology), Bipolar Disorder (diagnosis), Bipolar Disorder (diagnostic imaging), Bipolar Disorder (etiology), Bipolar Disorder (physiopathology), Brain (blood supply), Brain (diagnostic imaging), Brain (physiopathology), Brain Mapping (methods), Deep Brain Stimulation (adverse effects), Deep Brain Stimulation (methods), Female, Humans, Implantable Neurostimulators, Magnetic Resonance Imaging (methods), Male, Middle Aged, Parkinson Disease (complications), Parkinson Disease (diagnostic imaging), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Positron-Emission Tomography (methods), Psychomotor Performance (physiology), Substantia Nigra (diagnostic imaging), Substantia Nigra (physiopathology), Subthalamic Nucleus (diagnostic imaging), Subthalamic Nucleus (physiopathology), Subthalamic Nucleus (surgery), Tomography, X-Ray Computed (methods).
- MESH :
- adverse effects : Deep Brain Stimulation.
- blood supply : Brain.
- complications : Parkinson Disease.
- diagnosis : Bipolar Disorder.
- diagnostic imaging : Bipolar Disorder, Brain, Parkinson Disease, Substantia Nigra, Subthalamic Nucleus.
- etiology : Bipolar Disorder.
- methods : Brain Mapping, Deep Brain Stimulation, Magnetic Resonance Imaging, Positron-Emission Tomography, Tomography, X-Ray Computed.
- physiology : Attention, Psychomotor Performance.
- physiopathology : Bipolar Disorder, Brain, Parkinson Disease, Substantia Nigra, Subthalamic Nucleus.
- surgery : Subthalamic Nucleus.
- therapy : Parkinson Disease.
- mix :
Abstract
Hypomanic symptoms depending on anatomical location of contacts are reported in patients with Parkinson's disease (PD) treated by deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, the underlying cortical and subcortical dysfunction is debated. In this study, five PD patients implanted with DBS–STN who presented with reversible and reproducible hypomanic symptoms after stimulation of specific ‘manic’ contacts were investigated. Hypomanic symptoms were assessed using the Bech and Rafaelsen Mania Scale (MAS). Three dimensional anatomical location of ‘euthymic’ and ‘manic’ contacts, after matching the postoperative CT scan with the preoperative stereotactic MRI, and a H215O positron emission tomography (PET) study testing ‘euthymic’ and ‘manic’ contacts, were performed. Under ‘euthymic’ conditions, MAS score (mean±SD) was 0.6±0.5 compared with 7.8±3.1 under ‘manic’ conditions. Nine of 10 ‘manic’ contacts were located in the substantia nigra, mainly in its ventral part. PET showed that hypomania was associated with strong asymmetrical cerebral activation involving preferentially the right hemisphere and was mediated by activation of the anterior cingulate and medial prefrontal cortex. The present study demonstrates the role of the subcortical structures in the genesis of hypomania in PD patients treated with DBS and stresses the involvement of the substantia nigra.
Url:
- https://api.istex.fr/document/2F5765A56A7A8F898F90DD3E118DA7CF87CE95F1/fulltext/pdf
- https://hal.archives-ouvertes.fr/hal-00591165
DOI: 10.1136/jnnp.2009.199323
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<term>Bipolar Disorder (diagnosis)</term>
<term>Bipolar Disorder (diagnostic imaging)</term>
<term>Bipolar Disorder (etiology)</term>
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<front><div type="abstract">Hypomanic symptoms depending on anatomical location of contacts are reported in patients with Parkinson's disease (PD) treated by deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, the underlying cortical and subcortical dysfunction is debated. In this study, five PD patients implanted with DBS–STN who presented with reversible and reproducible hypomanic symptoms after stimulation of specific ‘manic’ contacts were investigated. Hypomanic symptoms were assessed using the Bech and Rafaelsen Mania Scale (MAS). Three dimensional anatomical location of ‘euthymic’ and ‘manic’ contacts, after matching the postoperative CT scan with the preoperative stereotactic MRI, and a H215O positron emission tomography (PET) study testing ‘euthymic’ and ‘manic’ contacts, were performed. Under ‘euthymic’ conditions, MAS score (mean±SD) was 0.6±0.5 compared with 7.8±3.1 under ‘manic’ conditions. Nine of 10 ‘manic’ contacts were located in the substantia nigra, mainly in its ventral part. PET showed that hypomania was associated with strong asymmetrical cerebral activation involving preferentially the right hemisphere and was mediated by activation of the anterior cingulate and medial prefrontal cortex. The present study demonstrates the role of the subcortical structures in the genesis of hypomania in PD patients treated with DBS and stresses the involvement of the substantia nigra.</div>
</front>
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<series><title level="j">Journal of Neurology, Neurosurgery and Psychiatry</title>
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<front><div type="abstract" xml:lang="en">Hypomanic symptoms depending on anatomical location of contacts are reported in Parkinson's disease (PD) patients treated by deep-brain-stimulation (DBS) of subthalamic nucleus (STN) area. However, the underlying cortical and subcortical dysfunction remains debated. In this study, we investigated five PD patients implanted with DBS-STN who presented reversible and reproducible hypomanic symptoms after stimulation of specific "manic" contacts. Hypomanic symptoms were assessed using the Bech and Rafaelsen Mania Scale (MAS). A 3-D anatomical location of "euthymic" and "manic" contacts, after matching post operative CT scan with pre-operative stereotactic MRI, and a H215O PET study in conditions testing "euthymic" and "manic" contacts, were performed. In the "euthymic" condition, MAS score (mean ± SD) was 0.6 ± 0.5 compared to 7.8 ± 3.1 in the "manic" condition. Nine of ten "manic" contacts were located in the substantia nigra mainly in its ventral part. PET showed that hypomania was associated with a strong asymmetrical cerebral activation involving preferentially the right hemisphere, and was mediated by an activation of the anterior cingulate and medial prefrontal cortex. The present study demonstrates the role of subcortical structures in the genesis of hypomania in PD patients treated with DBS and stresses the implication of substantia nigra.</div>
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<front><div type="abstract">Hypomanic symptoms depending on anatomical location of contacts are reported in patients with Parkinson's disease (PD) treated by deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, the underlying cortical and subcortical dysfunction is debated. In this study, five PD patients implanted with DBS–STN who presented with reversible and reproducible hypomanic symptoms after stimulation of specific ‘manic’ contacts were investigated. Hypomanic symptoms were assessed using the Bech and Rafaelsen Mania Scale (MAS). Three dimensional anatomical location of ‘euthymic’ and ‘manic’ contacts, after matching the postoperative CT scan with the preoperative stereotactic MRI, and a H215O positron emission tomography (PET) study testing ‘euthymic’ and ‘manic’ contacts, were performed. Under ‘euthymic’ conditions, MAS score (mean±SD) was 0.6±0.5 compared with 7.8±3.1 under ‘manic’ conditions. Nine of 10 ‘manic’ contacts were located in the substantia nigra, mainly in its ventral part. PET showed that hypomania was associated with strong asymmetrical cerebral activation involving preferentially the right hemisphere and was mediated by activation of the anterior cingulate and medial prefrontal cortex. The present study demonstrates the role of the subcortical structures in the genesis of hypomania in PD patients treated with DBS and stresses the involvement of the substantia nigra.</div>
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<series><title level="j">Journal of neurology, neurosurgery, and psychiatry</title>
<idno type="eISSN">1468-330X</idno>
<imprint><date when="2011" type="published">2011</date>
</imprint>
</series>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Attention (physiology)</term>
<term>Bipolar Disorder (diagnosis)</term>
<term>Bipolar Disorder (diagnostic imaging)</term>
<term>Bipolar Disorder (etiology)</term>
<term>Bipolar Disorder (physiopathology)</term>
<term>Brain (blood supply)</term>
<term>Brain (diagnostic imaging)</term>
<term>Brain (physiopathology)</term>
<term>Brain Mapping (methods)</term>
<term>Deep Brain Stimulation (adverse effects)</term>
<term>Deep Brain Stimulation (methods)</term>
<term>Female</term>
<term>Humans</term>
<term>Implantable Neurostimulators</term>
<term>Magnetic Resonance Imaging (methods)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (diagnostic imaging)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Positron-Emission Tomography (methods)</term>
<term>Psychomotor Performance (physiology)</term>
<term>Substantia Nigra (diagnostic imaging)</term>
<term>Substantia Nigra (physiopathology)</term>
<term>Subthalamic Nucleus (diagnostic imaging)</term>
<term>Subthalamic Nucleus (physiopathology)</term>
<term>Subthalamic Nucleus (surgery)</term>
<term>Tomography, X-Ray Computed (methods)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Deep Brain Stimulation</term>
</keywords>
<keywords scheme="MESH" qualifier="blood supply" xml:lang="en"><term>Brain</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Bipolar Disorder</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Bipolar Disorder</term>
<term>Brain</term>
<term>Parkinson Disease</term>
<term>Substantia Nigra</term>
<term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Bipolar Disorder</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Brain Mapping</term>
<term>Deep Brain Stimulation</term>
<term>Magnetic Resonance Imaging</term>
<term>Positron-Emission Tomography</term>
<term>Tomography, X-Ray Computed</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Attention</term>
<term>Psychomotor Performance</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Bipolar Disorder</term>
<term>Brain</term>
<term>Parkinson Disease</term>
<term>Substantia Nigra</term>
<term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Female</term>
<term>Humans</term>
<term>Implantable Neurostimulators</term>
<term>Male</term>
<term>Middle Aged</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Hypomanic symptoms depending on anatomical location of contacts are reported in patients with Parkinson's disease (PD) treated by deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, the underlying cortical and subcortical dysfunction is debated. In this study, five PD patients implanted with DBS-STN who presented with reversible and reproducible hypomanic symptoms after stimulation of specific 'manic' contacts were investigated. Hypomanic symptoms were assessed using the Bech and Rafaelsen Mania Scale (MAS). Three dimensional anatomical location of 'euthymic' and 'manic' contacts, after matching the postoperative CT scan with the preoperative stereotactic MRI, and a H(2)(15)O positron emission tomography (PET) study testing 'euthymic' and 'manic' contacts, were performed. Under 'euthymic' conditions, MAS score (mean±SD) was 0.6±0.5 compared with 7.8±3.1 under 'manic' conditions. Nine of 10 'manic' contacts were located in the substantia nigra, mainly in its ventral part. PET showed that hypomania was associated with strong asymmetrical cerebral activation involving preferentially the right hemisphere and was mediated by activation of the anterior cingulate and medial prefrontal cortex. The present study demonstrates the role of the subcortical structures in the genesis of hypomania in PD patients treated with DBS and stresses the involvement of the substantia nigra.</div>
</front>
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