Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease
Identifieur interne : 003316 ( Main/Merge ); précédent : 003315; suivant : 003317Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease
Auteurs : A. Funkiewiez [France] ; C. Ardouin [France] ; E. Caputo [Italie] ; P. Krack [France] ; V. Fraix [France] ; H. Klinger [France] ; S. Chabardes [France] ; K. Foote [France] ; A-L Benabid [France] ; P. Pollak [France]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2004-06.
English descriptors
- KwdEn :
- Aged, BDI, Beck depression inventory, Cognition Disorders (therapy), Electric Stimulation Therapy (methods), Female, Frontal Lobe (physiology), Functional Laterality (physiology), Humans, MDRS, Mattis dementia rating scale, Male, Mental Disorders (diagnosis), Mental Disorders (therapy), Middle Aged, Mood Disorders (diagnosis), Mood Disorders (therapy), Neuropsychological Tests (statistics & numerical data), PD, Parkinson’s disease, Parkinson Disease (psychology), Parkinson Disease (surgery), Parkinson Disease (therapy), Parkinson’s disease, Postoperative Complications (diagnosis), Postoperative Complications (therapy), Psychiatric Status Rating Scales, STN DBS, subthalamic deep brain stimulation, STN stimulation, Subthalamic Nucleus (physiology), Treatment Outcome, UPDRS, unified Parkinson’s disease rating scale, WCST, Wisconsin card sorting test, cognition, mood.
- MESH :
- diagnosis : Mental Disorders, Mood Disorders, Postoperative Complications.
- methods : Electric Stimulation Therapy.
- physiology : Frontal Lobe, Functional Laterality, Subthalamic Nucleus.
- psychology : Parkinson Disease.
- statistics & numerical data : Neuropsychological Tests.
- surgery : Parkinson Disease.
- therapy : Cognition Disorders, Mental Disorders, Mood Disorders, Parkinson Disease, Postoperative Complications.
- Aged, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Treatment Outcome.
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.
Url:
- https://api.istex.fr/document/A8F47CC6437D8D68F7D5A02679410056F32FDD1F/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1739075
DOI: 10.1136/jnnp.2002.009803
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Pollak</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></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>Aged</term><term>BDI, Beck depression inventory</term><term>Cognition Disorders (therapy)</term><term>Electric Stimulation Therapy (methods)</term><term>Female</term><term>Frontal Lobe (physiology)</term><term>Functional Laterality (physiology)</term><term>Humans</term><term>MDRS, Mattis dementia rating scale</term><term>Male</term><term>Mental Disorders (diagnosis)</term><term>Mental Disorders (therapy)</term><term>Middle Aged</term><term>Mood Disorders (diagnosis)</term><term>Mood Disorders (therapy)</term><term>Neuropsychological Tests (statistics & numerical data)</term><term>PD, Parkinson’s disease</term><term>Parkinson Disease (psychology)</term><term>Parkinson Disease (surgery)</term><term>Parkinson Disease (therapy)</term><term>Parkinson’s disease</term><term>Postoperative Complications (diagnosis)</term><term>Postoperative Complications (therapy)</term><term>Psychiatric Status Rating Scales</term><term>STN DBS, subthalamic deep brain stimulation</term><term>STN stimulation</term><term>Subthalamic Nucleus (physiology)</term><term>Treatment Outcome</term><term>UPDRS, unified Parkinson’s disease rating scale</term><term>WCST, Wisconsin card sorting test</term><term>cognition</term><term>mood</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Mental Disorders</term><term>Mood Disorders</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Frontal Lobe</term><term>Functional Laterality</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Neuropsychological Tests</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Cognition Disorders</term><term>Mental Disorders</term><term>Mood Disorders</term><term>Parkinson Disease</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Psychiatric Status Rating Scales</term><term>Treatment Outcome</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><double doi="10.1136/jnnp.2002.009803"><ISTEX><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></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C" last="Ardouin">C. Ardouin</name></author><author><name sortKey="Caputo, E" sort="Caputo, E" uniqKey="Caputo E" first="E" last="Caputo">E. Caputo</name></author><author><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P" last="Krack">P. Krack</name></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V" last="Fraix">V. Fraix</name></author><author><name sortKey="Klinger, H" sort="Klinger, H" uniqKey="Klinger H" first="H" last="Klinger">H. Klinger</name></author><author><name sortKey="Chabardes, S" sort="Chabardes, S" uniqKey="Chabardes S" first="S" last="Chabardes">S. Chabardes</name></author><author><name sortKey="Foote, K" sort="Foote, K" uniqKey="Foote K" first="K" last="Foote">K. Foote</name></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A-L" last="Benabid">A-L Benabid</name></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P" last="Pollak">P. Pollak</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:A8F47CC6437D8D68F7D5A02679410056F32FDD1F</idno><date when="2004" year="2004">2004</date><idno type="doi">10.1136/jnnp.2002.009803</idno><idno type="url">https://api.istex.fr/document/A8F47CC6437D8D68F7D5A02679410056F32FDD1F/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002484</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002484</idno><idno type="wicri:Area/Istex/Curation">002482</idno><idno type="wicri:Area/Istex/Checkpoint">000B99</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">000B99</idno><idno type="wicri:doubleKey">0022-3050:2004:Funkiewiez A:long:term:effects</idno></publicationStmt><sourceDesc><biblStruct><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><name sortKey="Funkiewiez, A" sort="Funkiewiez, A" uniqKey="Funkiewiez A" first="A" last="Funkiewiez">A. Funkiewiez</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C" last="Ardouin">C. Ardouin</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Caputo, E" sort="Caputo, E" uniqKey="Caputo E" first="E" last="Caputo">E. Caputo</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neurology, Ospedale San Paolo, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P" last="Krack">P. Krack</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V" last="Fraix">V. Fraix</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Klinger, H" sort="Klinger, H" uniqKey="Klinger H" first="H" last="Klinger">H. Klinger</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Chabardes, S" sort="Chabardes, S" uniqKey="Chabardes S" first="S" last="Chabardes">S. Chabardes</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Foote, K" sort="Foote, K" uniqKey="Foote K" first="K" last="Foote">K. Foote</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></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 wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P" last="Pollak">P. Pollak</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></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><PMC><TEI><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></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C" last="Ardouin">C. Ardouin</name></author><author><name sortKey="Caputo, E" sort="Caputo, E" uniqKey="Caputo E" first="E" last="Caputo">E. Caputo</name></author><author><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P" last="Krack">P. Krack</name></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V" last="Fraix">V. Fraix</name></author><author><name sortKey="Klinger, H" sort="Klinger, H" uniqKey="Klinger H" first="H" last="Klinger">H. Klinger</name></author><author><name sortKey="Chabardes, S" sort="Chabardes, S" uniqKey="Chabardes S" first="S" last="Chabardes">S. Chabardes</name></author><author><name sortKey="Foote, K" sort="Foote, K" uniqKey="Foote K" first="K" last="Foote">K. Foote</name></author><author><name sortKey="Benabid, A" sort="Benabid, A" uniqKey="Benabid A" first="A" last="Benabid">A. Benabid</name></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P" last="Pollak">P. Pollak</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">15145995</idno><idno type="pmc">1739075</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1739075</idno><idno type="RBID">PMC:1739075</idno><idno type="doi">10.1136/jnnp.2002.009803</idno><date when="2004">2004</date><idno type="wicri:Area/Pmc/Corpus">000497</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000497</idno><idno type="wicri:Area/Pmc/Curation">000494</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000494</idno><idno type="wicri:Area/Pmc/Checkpoint">000920</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000920</idno><idno type="wicri:source">PubMed</idno><idno type="wicri:Area/PubMed/Corpus">001014</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001014</idno><idno type="wicri:Area/PubMed/Curation">000F73</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000F73</idno><idno type="wicri:Area/PubMed/Checkpoint">000F73</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000F73</idno><idno type="wicri:Area/Ncbi/Merge">000441</idno><idno type="wicri:Area/Ncbi/Curation">000441</idno><idno type="wicri:Area/Ncbi/Checkpoint">000441</idno><idno type="wicri:doubleKey">0022-3050:2004:Funkiewiez A:long:term:effects</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">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></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C" last="Ardouin">C. Ardouin</name></author><author><name sortKey="Caputo, E" sort="Caputo, E" uniqKey="Caputo E" first="E" last="Caputo">E. Caputo</name></author><author><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P" last="Krack">P. Krack</name></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V" last="Fraix">V. Fraix</name></author><author><name sortKey="Klinger, H" sort="Klinger, H" uniqKey="Klinger H" first="H" last="Klinger">H. Klinger</name></author><author><name sortKey="Chabardes, S" sort="Chabardes, S" uniqKey="Chabardes S" first="S" last="Chabardes">S. Chabardes</name></author><author><name sortKey="Foote, K" sort="Foote, K" uniqKey="Foote K" first="K" last="Foote">K. Foote</name></author><author><name sortKey="Benabid, A" sort="Benabid, A" uniqKey="Benabid A" first="A" last="Benabid">A. Benabid</name></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P" last="Pollak">P. Pollak</name></author></analytic><series><title level="j">Journal of Neurology, Neurosurgery, and Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Cognition Disorders (therapy)</term><term>Electric Stimulation Therapy (methods)</term><term>Female</term><term>Frontal Lobe (physiology)</term><term>Functional Laterality (physiology)</term><term>Humans</term><term>Male</term><term>Mental Disorders (diagnosis)</term><term>Mental Disorders (therapy)</term><term>Middle Aged</term><term>Mood Disorders (diagnosis)</term><term>Mood Disorders (therapy)</term><term>Neuropsychological Tests (statistics & numerical data)</term><term>Parkinson Disease (psychology)</term><term>Parkinson Disease (surgery)</term><term>Parkinson Disease (therapy)</term><term>Postoperative Complications (diagnosis)</term><term>Postoperative Complications (therapy)</term><term>Psychiatric Status Rating Scales</term><term>Subthalamic Nucleus (physiology)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Mental Disorders</term><term>Mood Disorders</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Frontal Lobe</term><term>Functional Laterality</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Neuropsychological Tests</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Cognition Disorders</term><term>Mental Disorders</term><term>Mood Disorders</term><term>Parkinson Disease</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Psychiatric Status Rating Scales</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="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></div></front></TEI></PMC></double></record>Pour manipuler ce document sous Unix (Dilib)
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