Behavioural disorders, Parkinson's disease and subthalamic stimulation. Commentary
Identifieur interne : 003A83 ( Main/Merge ); précédent : 003A82; suivant : 003A84Behavioural disorders, Parkinson's disease and subthalamic stimulation. Commentary
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] ; R. G. Brown [Royaume-Uni]Source :
- Journal of neurology, neurosurgery and psychiatry [ 0022-3050 ] ; 2002.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
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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.
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Tezenas Du Moncel</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Services de Informatique Médicale, Hôpital de la Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. 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Pidoux</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Fédération de Neurophysiologie Clinique, Hôpital de la Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Dormont, D" sort="Dormont, D" uniqKey="Dormont D" first="D." last="Dormont">D. Dormont</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Services de Neuroradiologie, Hôpital de la Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Cornu, P" sort="Cornu, P" uniqKey="Cornu P" first="P." last="Cornu">P. Cornu</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Services de Neurochirurgie, Hôpital de la Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Fédération de Neurologie and INSERM U 289</wicri:noRegion><wicri:noRegion>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</wicri:noRegion><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author><author><name sortKey="Brown, R G" sort="Brown, R G" uniqKey="Brown R" first="R. G." last="Brown">R. G. Brown</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Department of Psychology, Institute of Psychiatry, King's College London, De Crespigny Park</s1><s2>London SE5 8AF</s2><s3>GBR</s3><sZ>12 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>London SE5 8AF</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">02-0358202</idno><date when="2002">2002</date><idno type="stanalyst">PASCAL 02-0358202 INIST</idno><idno type="RBID">Pascal:02-0358202</idno><idno type="wicri:Area/PascalFrancis/Corpus">001085</idno><idno type="wicri:Area/PascalFrancis/Curation">000351</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000F68</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000F68</idno><idno type="wicri:doubleKey">0022-3050:2002:Houeto J:behavioural:disorders:parkinson</idno><idno type="wicri:Area/Main/Merge">003A83</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Behavioural disorders, Parkinson's disease and subthalamic stimulation. Commentary</title><author><name sortKey="Houeto, J L" sort="Houeto, J L" uniqKey="Houeto J" first="J. L." last="Houeto">J. L. Houeto</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Fédération de Neurologie and INSERM U 289</wicri:noRegion><wicri:noRegion>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</wicri:noRegion></affiliation></author><author><name sortKey="Mesnage, V" sort="Mesnage, V" uniqKey="Mesnage V" first="V." last="Mesnage">V. Mesnage</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Fédération de Neurologie and INSERM U 289</wicri:noRegion><wicri:noRegion>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</wicri:noRegion></affiliation></author><author><name sortKey="Mallet, L" sort="Mallet, L" uniqKey="Mallet L" first="L." last="Mallet">L. Mallet</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Services de Psychiatrie, Hôpital de la Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Pillon, B" sort="Pillon, B" uniqKey="Pillon B" first="B." last="Pillon">B. Pillon</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>INSERM E 007</s1><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>INSERM E 007</wicri:noRegion><wicri:noRegion>INSERM E 007</wicri:noRegion></affiliation></author><author><name sortKey="Gargiulo, M" sort="Gargiulo, M" uniqKey="Gargiulo M" first="M." last="Gargiulo">M. Gargiulo</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Fédération de Neurologie and INSERM U 289</wicri:noRegion><wicri:noRegion>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</wicri:noRegion></affiliation></author><author><name sortKey="Tezenas Du Moncel, S" sort="Tezenas Du Moncel, S" uniqKey="Tezenas Du Moncel S" first="S." last="Tezenas Du Moncel">S. Tezenas Du Moncel</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Services de Informatique Médicale, Hôpital de la Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. Bonnet</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Fédération de Neurologie and INSERM U 289</wicri:noRegion><wicri:noRegion>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</wicri:noRegion></affiliation></author><author><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Fédération de Neurophysiologie Clinique, Hôpital de la Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Dormont, D" sort="Dormont, D" uniqKey="Dormont D" first="D." last="Dormont">D. Dormont</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Services de Neuroradiologie, Hôpital de la Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Cornu, P" sort="Cornu, P" uniqKey="Cornu P" first="P." last="Cornu">P. Cornu</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Services de Neurochirurgie, Hôpital de la Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Fédération de Neurologie and INSERM U 289</wicri:noRegion><wicri:noRegion>Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289</wicri:noRegion><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author><author><name sortKey="Brown, R G" sort="Brown, R G" uniqKey="Brown R" first="R. G." last="Brown">R. G. Brown</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Department of Psychology, Institute of Psychiatry, King's College London, De Crespigny Park</s1><s2>London SE5 8AF</s2><s3>GBR</s3><sZ>12 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>London SE5 8AF</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Journal of neurology, neurosurgery and psychiatry</title><title level="j" type="abbreviated">J. neurol. neurosurg. psychiatry</title><idno type="ISSN">0022-3050</idno><imprint><date when="2002">2002</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of neurology, neurosurgery and psychiatry</title><title level="j" type="abbreviated">J. neurol. neurosurg. psychiatry</title><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Behavioral disorder</term><term>Bilateral</term><term>Complication</term><term>Frequency</term><term>Human</term><term>Instrumental stimulation</term><term>Parkinson disease</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Stimulation instrumentale</term><term>Noyau sousthalamique</term><term>Bilatéral</term><term>Trouble comportement</term><term>Complication</term><term>Fréquence</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><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></front></TEI><affiliations><list><country><li>France</li><li>Royaume-Uni</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement><orgName><li>Hôpital de la Salpêtrière</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Houeto, J L" sort="Houeto, J L" uniqKey="Houeto J" first="J. L." last="Houeto">J. L. Houeto</name></noRegion><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name><name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. Bonnet</name><name sortKey="Cornu, P" sort="Cornu, P" uniqKey="Cornu P" first="P." last="Cornu">P. Cornu</name><name sortKey="Dormont, D" sort="Dormont, D" uniqKey="Dormont D" first="D." last="Dormont">D. Dormont</name><name sortKey="Gargiulo, M" sort="Gargiulo, M" uniqKey="Gargiulo M" first="M." last="Gargiulo">M. Gargiulo</name><name sortKey="Mallet, L" sort="Mallet, L" uniqKey="Mallet L" first="L." last="Mallet">L. Mallet</name><name sortKey="Mesnage, V" sort="Mesnage, V" uniqKey="Mesnage V" first="V." last="Mesnage">V. Mesnage</name><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><name sortKey="Pillon, B" sort="Pillon, B" uniqKey="Pillon B" first="B." last="Pillon">B. Pillon</name><name sortKey="Tezenas Du Moncel, S" sort="Tezenas Du Moncel, S" uniqKey="Tezenas Du Moncel S" first="S." last="Tezenas Du Moncel">S. Tezenas Du Moncel</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Brown, R G" sort="Brown, R G" uniqKey="Brown R" first="R. G." last="Brown">R. G. Brown</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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