Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease
Identifieur interne : 000143 ( France/Analysis ); précédent : 000142; suivant : 000144Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease
Auteurs : Aurélie Funkiewiez [France] ; Claire Ardouin [France] ; Roshan Cools [Royaume-Uni] ; Paul Krack [France] ; Valérie Fraix [France] ; Alina Batir [France] ; Stephan Chabardès [France] ; Alim-Louis Benabid [France] ; Trevor W. Robbins [Royaume-Uni] ; Pierre Pollak [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2006-10.
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- KwdEn :
Abstract
In Parkinson's disease (PD), levodopa and subthalamic nucleus (STN) stimulation lead to major improvement in motor symptoms. Effects of both treatments on cognition and affective status are less well understood. Motor, cognitive, and affective symptoms may relate to the dysfunctioning of parallel cortico–striatal loops. The aim of this study was to assess cognition, behavior, and mood, with and without both treatments in the same group of PD patients. A group of 22 nondemented PD patients was included in this study. Patients were tested twice before surgery (off and on levodopa) and twice 3 months after surgery (OFF and ON STN stimulation, off levodopa). Cognitive and affective effects of STN stimulation and levodopa had some common, but also different, effects. STN stimulation improved performance on the planning test, associated with the dorsolateral prefrontal cortex. However, the treatments had opposite effects on tests associated with the orbitofrontal cortex; specifically, levodopa impaired while STN stimulation improved performance on the extinction phase of a reversal/extinction task. Acutely, both treatments improved motivation and decreased fatigue and anxiety. On chronic treatment (3 months after surgery), depression improved, whereas apathy worsened 3 months after surgery. To conclude, there were significant but contrasting effects of levodopa and STN stimulation on cognition and affective functions. © 2006 Movement Disorder Society
Url:
DOI: 10.1002/mds.21029
Affiliations:
- France, Royaume-Uni
- Angleterre, Angleterre de l'Est, Auvergne-Rhône-Alpes, Rhône-Alpes
- Cambridge, Grenoble
- Centre hospitalier universitaire Grenoble Alpes, Université de Cambridge
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ISTEX:C251B29A0A62D5658BD6BE76B8576D968157E64BLe document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2006-10">2006-10</date><biblScope unit="volume">21</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1656">1656</biblScope><biblScope unit="page" to="1662">1662</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">C251B29A0A62D5658BD6BE76B8576D968157E64B</idno><idno type="DOI">10.1002/mds.21029</idno><idno type="ArticleID">MDS21029</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>basal ganglia frontal loops</term><term>levodopa</term><term>neuropsychology</term><term>subthalamic nucleus stimulation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In Parkinson's disease (PD), levodopa and subthalamic nucleus (STN) stimulation lead to major improvement in motor symptoms. Effects of both treatments on cognition and affective status are less well understood. Motor, cognitive, and affective symptoms may relate to the dysfunctioning of parallel cortico–striatal loops. The aim of this study was to assess cognition, behavior, and mood, with and without both treatments in the same group of PD patients. A group of 22 nondemented PD patients was included in this study. Patients were tested twice before surgery (off and on levodopa) and twice 3 months after surgery (OFF and ON STN stimulation, off levodopa). Cognitive and affective effects of STN stimulation and levodopa had some common, but also different, effects. STN stimulation improved performance on the planning test, associated with the dorsolateral prefrontal cortex. However, the treatments had opposite effects on tests associated with the orbitofrontal cortex; specifically, levodopa impaired while STN stimulation improved performance on the extinction phase of a reversal/extinction task. Acutely, both treatments improved motivation and decreased fatigue and anxiety. On chronic treatment (3 months after surgery), depression improved, whereas apathy worsened 3 months after surgery. To conclude, there were significant but contrasting effects of levodopa and STN stimulation on cognition and affective functions. © 2006 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>France</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Angleterre de l'Est</li><li>Auvergne-Rhône-Alpes</li><li>Rhône-Alpes</li></region><settlement><li>Cambridge</li><li>Grenoble</li></settlement><orgName><li>Centre hospitalier universitaire Grenoble Alpes</li><li>Université de Cambridge</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Funkiewiez, Aurelie" sort="Funkiewiez, Aurelie" uniqKey="Funkiewiez A" first="Aurélie" last="Funkiewiez">Aurélie Funkiewiez</name></noRegion><name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name><name sortKey="Batir, Alina" sort="Batir, Alina" uniqKey="Batir A" first="Alina" last="Batir">Alina Batir</name><name sortKey="Benabid, Alim Ouis" sort="Benabid, Alim Ouis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardès">Stephan Chabardès</name><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valérie" last="Fraix">Valérie Fraix</name><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Cools, Roshan" sort="Cools, Roshan" uniqKey="Cools R" first="Roshan" last="Cools">Roshan Cools</name></region><name sortKey="Robbins, Trevor W" sort="Robbins, Trevor W" uniqKey="Robbins T" first="Trevor W." last="Robbins">Trevor W. 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