Behavioural disorders, Parkinson's disease and subthalamic stimulation
Identifieur interne : 000247 ( Ncbi/Merge ); précédent : 000246; suivant : 000248Behavioural disorders, Parkinson's disease and subthalamic stimulation
Auteurs : J. Houeto ; V. Mesnage ; L. Mallet ; B. Pillon ; M. Gargiulo ; S T. Du Moncel ; A. Bonnet ; B. Pidoux ; D. Dormont ; P. Cornu ; Yves Agid [France]Source :
- Journal of Neurology, Neurosurgery, and Psychiatry [ 0022-3050 ] ; 2002.
English descriptors
- KwdEn :
- Anxiety (etiology), Depression (etiology), Electric Stimulation Therapy (adverse effects), Female, Humans, Male, Mental Status Schedule, Middle Aged, Motor Skills Disorders (etiology), Motor Skills Disorders (therapy), Parkinson Disease (pathology), Parkinson Disease (therapy), Personality, Quality of Life, Social Behavior, Substance-Related Disorders, Subthalamic Nucleus (physiology), Treatment Outcome.
- 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
Url:
DOI: 10.1136/jnnp.72.6.701
PubMed: 12023409
PubMed Central: 1737905
Links toward previous steps (curation, corpus...)
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Links to Exploration step
PMC:1737905Le document en format XML
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<front><div type="abstract" xml:lang="en"><p><bold>Objective:</bold>
to analyse 24 parkinsonian patients successfully treated by bilateral STN stimulation for the presence of behavioural disorders. </p>
<p><bold>Method:</bold>
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). </p>
<p><bold>Results:</bold>
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 </p>
<p><bold>Conclusion:</bold>
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. </p>
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<front><div type="abstract" xml:lang="en"><p><bold>Objective:</bold>
to analyse 24 parkinsonian patients successfully treated by bilateral STN stimulation for the presence of behavioural disorders. </p>
<p><bold>Method:</bold>
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). </p>
<p><bold>Results:</bold>
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 </p>
<p><bold>Conclusion:</bold>
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. </p>
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<orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName>
<country>France</country>
<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>
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<series><title level="j">Journal of neurology, neurosurgery, and psychiatry</title>
<idno type="ISSN">0022-3050</idno>
<imprint><date when="2002" type="published">2002</date>
</imprint>
</series>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anxiety (etiology)</term>
<term>Depression (etiology)</term>
<term>Electric Stimulation Therapy (adverse effects)</term>
<term>Female</term>
<term>Humans</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>Personality</term>
<term>Quality of Life</term>
<term>Social Behavior</term>
<term>Substance-Related Disorders</term>
<term>Subthalamic Nucleus (physiology)</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Electric Stimulation Therapy</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Anxiety</term>
<term>Depression</term>
<term>Motor Skills Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Motor Skills Disorders</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Mental Status Schedule</term>
<term>Middle Aged</term>
<term>Personality</term>
<term>Quality of Life</term>
<term>Social Behavior</term>
<term>Substance-Related Disorders</term>
<term>Treatment Outcome</term>
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<front><div type="abstract" xml:lang="en">to analyse 24 parkinsonian patients successfully treated by bilateral STN stimulation for the presence of behavioural disorders.</div>
</front>
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