Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson's disease
Identifieur interne : 000C31 ( PascalFrancis/Checkpoint ); précédent : 000C30; suivant : 000C32Long 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 and psychiatry [ 0022-3050 ] ; 2004.
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- Pascal (Inist)
English descriptors
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.
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Ardouin</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="02"><s1>Department of Neurology, Ospedale San Paolo</s1><s2>Milan</s2><s3>ITA</s3><sZ>3 aut.</sZ></inist:fA14><country>Italie</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">04-0511787</idno><date when="2004">2004</date><idno type="stanalyst">PASCAL 04-0511787 INIST</idno><idno type="RBID">Pascal:04-0511787</idno><idno type="wicri:Area/PascalFrancis/Corpus">000D66</idno><idno type="wicri:Area/PascalFrancis/Curation">000668</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000C31</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000C31</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="02"><s1>Department of Neurology, Ospedale San Paolo</s1><s2>Milan</s2><s3>ITA</s3><sZ>3 aut.</sZ></inist:fA14><country>Italie</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></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="2004">2004</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>Long term</term><term>Mood</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Long terme</term><term>Noyau sousthalamique</term><term>Système nerveux pathologie</term><term>Humeur</term></keywords></textClass></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><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0022-3050</s0></fA01><fA02 i1="01"><s0>JNNPAU</s0></fA02><fA03 i2="1"><s0>J. neurol. neurosurg. psychiatry</s0></fA03><fA05><s2>75</s2></fA05><fA06><s2>6</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson's disease</s1></fA08><fA11 i1="01" i2="1"><s1>FUNKIEWIEZ (A.)</s1></fA11><fA11 i1="02" i2="1"><s1>ARDOUIN (C.)</s1></fA11><fA11 i1="03" i2="1"><s1>CAPUTO (E.)</s1></fA11><fA11 i1="04" i2="1"><s1>KRACK (P.)</s1></fA11><fA11 i1="05" i2="1"><s1>FRAIX (V.)</s1></fA11><fA11 i1="06" i2="1"><s1>KLINGER (H.)</s1></fA11><fA11 i1="07" i2="1"><s1>CHABARDES (S.)</s1></fA11><fA11 i1="08" i2="1"><s1>FOOTE (K.)</s1></fA11><fA11 i1="09" i2="1"><s1>BENABID (A-L)</s1></fA11><fA11 i1="10" i2="1"><s1>POLLAK (P.)</s1></fA11><fA14 i1="01"><s1>Department of Clinical and Biological Neurosciences, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neurology, Ospedale San Paolo</s1><s2>Milan</s2><s3>ITA</s3><sZ>3 aut.</sZ></fA14><fA20><s1>834-839</s1></fA20><fA21><s1>2004</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>6015</s2><s5>354000110319530070</s5></fA43><fA44><s0>0000</s0><s1>© 2004 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>49 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>04-0511787</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Journal of neurology, neurosurgery and psychiatry</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>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.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Parkinson maladie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Long terme</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Long term</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Largo plazo</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Noyau sousthalamique</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Subthalamic nucleus</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Núcleo subtalámico</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Humeur</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Mood</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Humor</s0><s5>05</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Encéphale pathologie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Système nerveux central</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Central nervous system</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervioso central</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>41</s5></fC07><fN21><s1>292</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>France</li><li>Italie</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Lombardie</li><li>Rhône-Alpes</li></region><settlement><li>Grenoble</li><li>Milan</li></settlement></list><tree><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Funkiewiez, A" sort="Funkiewiez, A" uniqKey="Funkiewiez A" first="A." last="Funkiewiez">A. Funkiewiez</name></region><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C." last="Ardouin">C. Ardouin</name><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A-L" last="Benabid">A-L Benabid</name><name sortKey="Chabardes, S" sort="Chabardes, S" uniqKey="Chabardes S" first="S." last="Chabardes">S. Chabardes</name><name sortKey="Foote, K" sort="Foote, K" uniqKey="Foote K" first="K." last="Foote">K. Foote</name><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V." last="Fraix">V. Fraix</name><name sortKey="Klinger, H" sort="Klinger, H" uniqKey="Klinger H" first="H." last="Klinger">H. Klinger</name><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P." last="Krack">P. Krack</name><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name></country><country name="Italie"><region name="Lombardie"><name sortKey="Caputo, E" sort="Caputo, E" uniqKey="Caputo E" first="E." last="Caputo">E. Caputo</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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