Subthalamic stimulation in Parkinson's disease: restoring the balance of motivated behaviours.
Identifieur interne : 000E92 ( Ncbi/Curation ); précédent : 000E91; suivant : 000E93Subthalamic stimulation in Parkinson's disease: restoring the balance of motivated behaviours.
Auteurs : Eugénie Lhommée [France] ; Hélène Klinger ; Stéphane Thobois ; Emmanuelle Schmitt ; Claire Ardouin ; Amélie Bichon ; Andrea Kistner ; Valérie Fraix ; Jing Xie ; Magaly Aya Kombo ; Stephan Chabardès ; Eric Seigneuret ; Alim-Louis Benabid ; Patrick Mertens ; Gustavo Polo ; Sebastien Carnicella ; Jean-Louis Quesada ; Jean-Luc Bosson ; Emmanuel Broussolle ; Pierre Pollak ; Paul KrackSource :
- Brain : a journal of neurology [ 1460-2156 ] ; 2012.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (adverse effects), Cohort Studies, Deep Brain Stimulation (methods), Disruptive, Impulse Control, and Conduct Disorders (etiology), Disruptive, Impulse Control, and Conduct Disorders (therapy), Dyskinesia, Drug-Induced (etiology), Dyskinesia, Drug-Induced (therapy), Female, Humans, Levodopa (adverse effects), Levodopa (therapeutic use), Male, Middle Aged, Motivation (drug effects), Motivation (physiology), Neuropsychological Tests, Parkinson Disease (complications), Parkinson Disease (therapy), Psychiatric Status Rating Scales, Severity of Illness Index, Statistics, Nonparametric, Subthalamic Nucleus (physiology).
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- complications : Parkinson Disease.
- drug effects : Motivation.
- etiology : Disruptive, Impulse Control, and Conduct Disorders, Dyskinesia, Drug-Induced.
- methods : Deep Brain Stimulation.
- physiology : Motivation, Subthalamic Nucleus.
- chemical , therapeutic use : Levodopa.
- therapy : Disruptive, Impulse Control, and Conduct Disorders, Dyskinesia, Drug-Induced, Parkinson Disease.
- Aged, Cohort Studies, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Severity of Illness Index, Statistics, Nonparametric.
Abstract
Addictions to dopaminergic drugs or to pleasant behaviours are frequent and potentially devastating neuropsychiatric disorders observed in Parkinson's disease. They encompass impulse control disorders, punding and dopamine dysregulation syndrome. A relationship with dopaminergic treatment is strongly suggested. Subthalamic stimulation improves motor complications and allows for drastic reductions in medication. This treatment might, therefore, be considered for patients with behavioural addictions, when attempts to reduce dopaminergic medication have failed. However, conflicting data have reported suppression, alleviation, worsening or new onset of behavioural addictions after subthalamic stimulation. Non-motor fluctuations are also a disabling feature of the disease. We prospectively investigated behaviour in a cohort of 63 patients with Parkinson's disease, before and 1 year after subthalamic stimulation using the Ardouin scale, with systematic evaluation of functioning in overall appetitive or apathetic modes, non-motor fluctuations, dopaminergic dysregulation syndrome, as well as behavioural addictions (including impulse control disorders and punding) and compulsive use of dopaminergic medication. Defined drug management included immediate postoperative discontinuation of dopamine agonists and reduction in levodopa. Motor and cognitive statuses were controlled (Unified Parkinson's Disease Rating Scale, Mattis Dementia Rating Scale, frontal score). After surgery, the OFF medication motor score improved (-45.2%), allowing for a 73% reduction in dopaminergic treatment, while overall cognitive evaluation was unchanged. Preoperative dopamine dysregulation syndrome had disappeared in 4/4, behavioural addictions in 17/17 and compulsive dopaminergic medication use in 9/9 patients. New onset of levodopa abuse occurred in one patient with surgical failure. Non-motor fluctuations were significantly reduced with improvements in off-dysphoria (P ≤ 0.001) and reduction in on-euphoria (P ≤ 0.001). There was an inversion in the number of patients functioning in an overall appetitive mode (29 before versus 2 after surgery, P ≤ 0.0001) to an overall apathetic mode (3 before versus 13 after surgery, P < 0.05). Two patients attempted suicide. Improvement in motor fluctuations is linked to the direct effect of stimulation on the sensory-motor subthalamic territory, while improvement in dyskinesias is mainly explained by an indirect effect related to the decrease in dopaminergic drugs. Our data suggest that non-motor fluctuations could similarly be directly alleviated through stimulation of the non-motor subthalamic territories, and hyperdopaminergic side effects might improve mainly due to the decrease in dopaminergic medication. We show an overall improvement in neuropsychiatric symptomatology and propose that disabling non-motor fluctuations, dopaminergic treatment abuse and drug-induced behavioural addictions in Parkinson's disease may be considered as new indications for subthalamic stimulation.
DOI: 10.1093/brain/aws078
PubMed: 22508959
Links toward previous steps (curation, corpus...)
- to stream PubMed, to step Corpus: Pour aller vers cette notice dans l'étape Curation :000870
- to stream PubMed, to step Curation: Pour aller vers cette notice dans l'étape Curation :000834
- to stream PubMed, to step Checkpoint: Pour aller vers cette notice dans l'étape Curation :000834
- to stream Ncbi, to step Merge: Pour aller vers cette notice dans l'étape Curation :000E92
Links to Exploration step
pubmed:22508959Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Subthalamic stimulation in Parkinson's disease: restoring the balance of motivated behaviours.</title>
<author><name sortKey="Lhommee, Eugenie" sort="Lhommee, Eugenie" uniqKey="Lhommee E" first="Eugénie" last="Lhommée">Eugénie Lhommée</name>
<affiliation wicri:level="1"><nlm:affiliation>CHU de Grenoble, Pavillon de neurology, Grenoble Cedex 9, France. ELhommee@chu-grenoble.fr</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>CHU de Grenoble, Pavillon de neurology, Grenoble Cedex 9</wicri:regionArea>
<wicri:noRegion>Grenoble Cedex 9</wicri:noRegion>
<wicri:noRegion>Grenoble Cedex 9</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Klinger, Helene" sort="Klinger, Helene" uniqKey="Klinger H" first="Hélène" last="Klinger">Hélène Klinger</name>
</author>
<author><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stéphane" last="Thobois">Stéphane Thobois</name>
</author>
<author><name sortKey="Schmitt, Emmanuelle" sort="Schmitt, Emmanuelle" uniqKey="Schmitt E" first="Emmanuelle" last="Schmitt">Emmanuelle Schmitt</name>
</author>
<author><name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name>
</author>
<author><name sortKey="Bichon, Amelie" sort="Bichon, Amelie" uniqKey="Bichon A" first="Amélie" last="Bichon">Amélie Bichon</name>
</author>
<author><name sortKey="Kistner, Andrea" sort="Kistner, Andrea" uniqKey="Kistner A" first="Andrea" last="Kistner">Andrea Kistner</name>
</author>
<author><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valérie" last="Fraix">Valérie Fraix</name>
</author>
<author><name sortKey="Xie, Jing" sort="Xie, Jing" uniqKey="Xie J" first="Jing" last="Xie">Jing Xie</name>
</author>
<author><name sortKey="Aya Kombo, Magaly" sort="Aya Kombo, Magaly" uniqKey="Aya Kombo M" first="Magaly" last="Aya Kombo">Magaly Aya Kombo</name>
</author>
<author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardès">Stephan Chabardès</name>
</author>
<author><name sortKey="Seigneuret, Eric" sort="Seigneuret, Eric" uniqKey="Seigneuret E" first="Eric" last="Seigneuret">Eric Seigneuret</name>
</author>
<author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name>
</author>
<author><name sortKey="Mertens, Patrick" sort="Mertens, Patrick" uniqKey="Mertens P" first="Patrick" last="Mertens">Patrick Mertens</name>
</author>
<author><name sortKey="Polo, Gustavo" sort="Polo, Gustavo" uniqKey="Polo G" first="Gustavo" last="Polo">Gustavo Polo</name>
</author>
<author><name sortKey="Carnicella, Sebastien" sort="Carnicella, Sebastien" uniqKey="Carnicella S" first="Sebastien" last="Carnicella">Sebastien Carnicella</name>
</author>
<author><name sortKey="Quesada, Jean Louis" sort="Quesada, Jean Louis" uniqKey="Quesada J" first="Jean-Louis" last="Quesada">Jean-Louis Quesada</name>
</author>
<author><name sortKey="Bosson, Jean Luc" sort="Bosson, Jean Luc" uniqKey="Bosson J" first="Jean-Luc" last="Bosson">Jean-Luc Bosson</name>
</author>
<author><name sortKey="Broussolle, Emmanuel" sort="Broussolle, Emmanuel" uniqKey="Broussolle E" first="Emmanuel" last="Broussolle">Emmanuel Broussolle</name>
</author>
<author><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name>
</author>
<author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="2012">2012</date>
<idno type="RBID">pubmed:22508959</idno>
<idno type="pmid">22508959</idno>
<idno type="doi">10.1093/brain/aws078</idno>
<idno type="wicri:Area/PubMed/Corpus">000870</idno>
<idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000870</idno>
<idno type="wicri:Area/PubMed/Curation">000834</idno>
<idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000834</idno>
<idno type="wicri:Area/PubMed/Checkpoint">000834</idno>
<idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000834</idno>
<idno type="wicri:Area/Ncbi/Merge">000E92</idno>
<idno type="wicri:Area/Ncbi/Curation">000E92</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en">Subthalamic stimulation in Parkinson's disease: restoring the balance of motivated behaviours.</title>
<author><name sortKey="Lhommee, Eugenie" sort="Lhommee, Eugenie" uniqKey="Lhommee E" first="Eugénie" last="Lhommée">Eugénie Lhommée</name>
<affiliation wicri:level="1"><nlm:affiliation>CHU de Grenoble, Pavillon de neurology, Grenoble Cedex 9, France. ELhommee@chu-grenoble.fr</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>CHU de Grenoble, Pavillon de neurology, Grenoble Cedex 9</wicri:regionArea>
<wicri:noRegion>Grenoble Cedex 9</wicri:noRegion>
<wicri:noRegion>Grenoble Cedex 9</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Klinger, Helene" sort="Klinger, Helene" uniqKey="Klinger H" first="Hélène" last="Klinger">Hélène Klinger</name>
</author>
<author><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stéphane" last="Thobois">Stéphane Thobois</name>
</author>
<author><name sortKey="Schmitt, Emmanuelle" sort="Schmitt, Emmanuelle" uniqKey="Schmitt E" first="Emmanuelle" last="Schmitt">Emmanuelle Schmitt</name>
</author>
<author><name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name>
</author>
<author><name sortKey="Bichon, Amelie" sort="Bichon, Amelie" uniqKey="Bichon A" first="Amélie" last="Bichon">Amélie Bichon</name>
</author>
<author><name sortKey="Kistner, Andrea" sort="Kistner, Andrea" uniqKey="Kistner A" first="Andrea" last="Kistner">Andrea Kistner</name>
</author>
<author><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valérie" last="Fraix">Valérie Fraix</name>
</author>
<author><name sortKey="Xie, Jing" sort="Xie, Jing" uniqKey="Xie J" first="Jing" last="Xie">Jing Xie</name>
</author>
<author><name sortKey="Aya Kombo, Magaly" sort="Aya Kombo, Magaly" uniqKey="Aya Kombo M" first="Magaly" last="Aya Kombo">Magaly Aya Kombo</name>
</author>
<author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardès">Stephan Chabardès</name>
</author>
<author><name sortKey="Seigneuret, Eric" sort="Seigneuret, Eric" uniqKey="Seigneuret E" first="Eric" last="Seigneuret">Eric Seigneuret</name>
</author>
<author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name>
</author>
<author><name sortKey="Mertens, Patrick" sort="Mertens, Patrick" uniqKey="Mertens P" first="Patrick" last="Mertens">Patrick Mertens</name>
</author>
<author><name sortKey="Polo, Gustavo" sort="Polo, Gustavo" uniqKey="Polo G" first="Gustavo" last="Polo">Gustavo Polo</name>
</author>
<author><name sortKey="Carnicella, Sebastien" sort="Carnicella, Sebastien" uniqKey="Carnicella S" first="Sebastien" last="Carnicella">Sebastien Carnicella</name>
</author>
<author><name sortKey="Quesada, Jean Louis" sort="Quesada, Jean Louis" uniqKey="Quesada J" first="Jean-Louis" last="Quesada">Jean-Louis Quesada</name>
</author>
<author><name sortKey="Bosson, Jean Luc" sort="Bosson, Jean Luc" uniqKey="Bosson J" first="Jean-Luc" last="Bosson">Jean-Luc Bosson</name>
</author>
<author><name sortKey="Broussolle, Emmanuel" sort="Broussolle, Emmanuel" uniqKey="Broussolle E" first="Emmanuel" last="Broussolle">Emmanuel Broussolle</name>
</author>
<author><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name>
</author>
<author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
</author>
</analytic>
<series><title level="j">Brain : a journal of neurology</title>
<idno type="eISSN">1460-2156</idno>
<imprint><date when="2012" type="published">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Antiparkinson Agents (adverse effects)</term>
<term>Cohort Studies</term>
<term>Deep Brain Stimulation (methods)</term>
<term>Disruptive, Impulse Control, and Conduct Disorders (etiology)</term>
<term>Disruptive, Impulse Control, and Conduct Disorders (therapy)</term>
<term>Dyskinesia, Drug-Induced (etiology)</term>
<term>Dyskinesia, Drug-Induced (therapy)</term>
<term>Female</term>
<term>Humans</term>
<term>Levodopa (adverse effects)</term>
<term>Levodopa (therapeutic use)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Motivation (drug effects)</term>
<term>Motivation (physiology)</term>
<term>Neuropsychological Tests</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (therapy)</term>
<term>Psychiatric Status Rating Scales</term>
<term>Severity of Illness Index</term>
<term>Statistics, Nonparametric</term>
<term>Subthalamic Nucleus (physiology)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term>
<term>Levodopa</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Motivation</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Disruptive, Impulse Control, and Conduct Disorders</term>
<term>Dyskinesia, Drug-Induced</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Motivation</term>
<term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Levodopa</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Disruptive, Impulse Control, and Conduct Disorders</term>
<term>Dyskinesia, Drug-Induced</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Cohort Studies</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neuropsychological Tests</term>
<term>Psychiatric Status Rating Scales</term>
<term>Severity of Illness Index</term>
<term>Statistics, Nonparametric</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Addictions to dopaminergic drugs or to pleasant behaviours are frequent and potentially devastating neuropsychiatric disorders observed in Parkinson's disease. They encompass impulse control disorders, punding and dopamine dysregulation syndrome. A relationship with dopaminergic treatment is strongly suggested. Subthalamic stimulation improves motor complications and allows for drastic reductions in medication. This treatment might, therefore, be considered for patients with behavioural addictions, when attempts to reduce dopaminergic medication have failed. However, conflicting data have reported suppression, alleviation, worsening or new onset of behavioural addictions after subthalamic stimulation. Non-motor fluctuations are also a disabling feature of the disease. We prospectively investigated behaviour in a cohort of 63 patients with Parkinson's disease, before and 1 year after subthalamic stimulation using the Ardouin scale, with systematic evaluation of functioning in overall appetitive or apathetic modes, non-motor fluctuations, dopaminergic dysregulation syndrome, as well as behavioural addictions (including impulse control disorders and punding) and compulsive use of dopaminergic medication. Defined drug management included immediate postoperative discontinuation of dopamine agonists and reduction in levodopa. Motor and cognitive statuses were controlled (Unified Parkinson's Disease Rating Scale, Mattis Dementia Rating Scale, frontal score). After surgery, the OFF medication motor score improved (-45.2%), allowing for a 73% reduction in dopaminergic treatment, while overall cognitive evaluation was unchanged. Preoperative dopamine dysregulation syndrome had disappeared in 4/4, behavioural addictions in 17/17 and compulsive dopaminergic medication use in 9/9 patients. New onset of levodopa abuse occurred in one patient with surgical failure. Non-motor fluctuations were significantly reduced with improvements in off-dysphoria (P ≤ 0.001) and reduction in on-euphoria (P ≤ 0.001). There was an inversion in the number of patients functioning in an overall appetitive mode (29 before versus 2 after surgery, P ≤ 0.0001) to an overall apathetic mode (3 before versus 13 after surgery, P < 0.05). Two patients attempted suicide. Improvement in motor fluctuations is linked to the direct effect of stimulation on the sensory-motor subthalamic territory, while improvement in dyskinesias is mainly explained by an indirect effect related to the decrease in dopaminergic drugs. Our data suggest that non-motor fluctuations could similarly be directly alleviated through stimulation of the non-motor subthalamic territories, and hyperdopaminergic side effects might improve mainly due to the decrease in dopaminergic medication. We show an overall improvement in neuropsychiatric symptomatology and propose that disabling non-motor fluctuations, dopaminergic treatment abuse and drug-induced behavioural addictions in Parkinson's disease may be considered as new indications for subthalamic stimulation.</div>
</front>
</TEI>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonFranceV1/Data/Ncbi/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000E92 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Ncbi/Curation/biblio.hfd -nk 000E92 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= ParkinsonFranceV1 |flux= Ncbi |étape= Curation |type= RBID |clé= pubmed:22508959 |texte= Subthalamic stimulation in Parkinson's disease: restoring the balance of motivated behaviours. }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Ncbi/Curation/RBID.i -Sk "pubmed:22508959" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Ncbi/Curation/biblio.hfd \ | NlmPubMed2Wicri -a ParkinsonFranceV1
![]() | This area was generated with Dilib version V0.6.29. | ![]() |