Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease
Identifieur interne : 001579 ( Main/Corpus ); précédent : 001578; suivant : 001580Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease
Auteurs : Aurélie Funkiewiez ; Claire Ardouin ; Roshan Cools ; Paul Krack ; Valérie Fraix ; Alina Batir ; Stephan Chabardès ; Alim-Louis Benabid ; Trevor W. Robbins ; Pierre PollakSource :
- Movement Disorders [ 0885-3185 ] ; 2006-10.
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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
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DOI: 10.1002/mds.21029
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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><istex><corpusName>wiley</corpusName><author><json:item><name>Aurélie Funkiewiez MA, PhD</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>Claire Ardouin</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>Roshan Cools</name><affiliations><json:string>Department of Experimental Psychology, University of Cambridge, United Kingdom</json:string></affiliations></json:item><json:item><name>Paul Krack</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>Valérie Fraix</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>Alina Batir</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>Stephan Chabardès</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>Alim‐Louis Benabid</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>Trevor W. 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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</abstract><qualityIndicators><score>6.544</score><pdfVersion>1.3</pdfVersion><pdfPageSize>594 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1468</abstractCharCount><pdfWordCount>4012</pdfWordCount><pdfCharCount>26630</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>211</abstractWordCount></qualityIndicators><title>Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>21</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>7</total><last>1662</last><first>1656</first></pages><issn><json:string>0885-3185</json:string></issn><issue>10</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2006</publicationDate><copyrightDate>2006</copyrightDate><doi><json:string>10.1002/mds.21029</json:string></doi><id>C251B29A0A62D5658BD6BE76B8576D968157E64B</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/C251B29A0A62D5658BD6BE76B8576D968157E64B/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/C251B29A0A62D5658BD6BE76B8576D968157E64B/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/C251B29A0A62D5658BD6BE76B8576D968157E64B/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2006</date></publicationStmt><notesStmt><note>Fifth PCRDT - No. QLK 6 CT‐1999‐02173;</note><note>INSERM</note><note>Royal Society Dorothy Hodgkin Fellowship</note><note>Junior Research Fellowship from St. John's College Cambridge</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease</title><author><persName><forename type="first">Aurélie</forename><surname>Funkiewiez</surname></persName><roleName type="degree">MA, PhD</roleName><note type="correspondence"><p>Correspondence: INSERM U610, Pavillon Claude Bernard, Hôpital de la Salpêtrière, 47 Bd de l'Hôpital, 75651 Paris Cedex 13, France</p></note><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation></author><author><persName><forename type="first">Claire</forename><surname>Ardouin</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation></author><author><persName><forename type="first">Roshan</forename><surname>Cools</surname></persName><affiliation>Department of Experimental Psychology, University of Cambridge, United Kingdom</affiliation></author><author><persName><forename type="first">Paul</forename><surname>Krack</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation></author><author><persName><forename type="first">Valérie</forename><surname>Fraix</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation></author><author><persName><forename type="first">Alina</forename><surname>Batir</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation></author><author><persName><forename type="first">Stephan</forename><surname>Chabardès</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation></author><author><persName><forename type="first">Alim‐Louis</forename><surname>Benabid</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation></author><author><persName><forename type="first">Trevor W.</forename><surname>Robbins</surname></persName><affiliation>Department of Experimental Psychology, University of Cambridge, United Kingdom</affiliation></author><author><persName><forename type="first">Pierre</forename><surname>Pollak</surname></persName><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. 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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</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>levodopa</term></item><item><term>subthalamic nucleus stimulation</term></item><item><term>basal ganglia frontal loops</term></item><item><term>Parkinson's disease</term></item><item><term>neuropsychology</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005-03-22">Received</change><change when="2005-12-01">Registration</change><change when="2006-10">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/C251B29A0A62D5658BD6BE76B8576D968157E64B/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="100"><doi origin="wiley" registered="yes">10.1002/mds.v21:10</doi><numberingGroup><numbering type="journalVolume" number="21">21</numbering><numbering type="journalIssue">10</numbering></numberingGroup><coverDate startDate="2006-10">October 2006</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="130" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.21029</doi><idGroup><id type="unit" value="MDS21029"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2006 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2005-03-22"></event><event type="manuscriptRevised" date="2005-11-30"></event><event type="manuscriptAccepted" date="2005-12-01"></event><event type="publishedOnlineEarlyUnpaginated" date="2006-07-07"></event><event type="firstOnline" date="2006-07-07"></event><event type="publishedOnlineFinalForm" date="2006-10-20"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.18.1 mode:FullText source:FullText result:FullText" date="2010-09-09"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">1656</numbering><numbering type="pageLast">1662</numbering></numberingGroup><correspondenceTo>INSERM U610, Pavillon Claude Bernard, Hôpital de la Salpêtrière, 47 Bd de l'Hôpital, 75651 Paris Cedex 13, France</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS21029.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="46"></count><count type="wordTotal" number="4515"></count></countGroup><titleGroup><title type="main" xml:lang="en">Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease</title><title type="short" xml:lang="en">Effects of Levodopa and STN Stimulation</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Aurélie</givenNames><familyName>Funkiewiez</familyName><degrees>MA, PhD</degrees></personName><contactDetails><email>a.funkiewiez@tiscali.fr</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Claire</givenNames><familyName>Ardouin</familyName></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Roshan</givenNames><familyName>Cools</familyName></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Paul</givenNames><familyName>Krack</familyName></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Valérie</givenNames><familyName>Fraix</familyName></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Alina</givenNames><familyName>Batir</familyName></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Stephan</givenNames><familyName>Chabardès</familyName></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Alim‐Louis</givenNames><familyName>Benabid</familyName></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Trevor W.</givenNames><familyName>Robbins</familyName></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Pierre</givenNames><familyName>Pollak</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="FR" type="organization"><unparsedAffiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="GB" type="organization"><unparsedAffiliation>Department of Experimental Psychology, University of Cambridge, United Kingdom</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">levodopa</keyword><keyword xml:id="kwd2">subthalamic nucleus stimulation</keyword><keyword xml:id="kwd3">basal ganglia frontal loops</keyword><keyword xml:id="kwd4">Parkinson's disease</keyword><keyword xml:id="kwd5">neuropsychology</keyword></keywordGroup><fundingInfo><fundingAgency>Fifth PCRDT</fundingAgency><fundingNumber>QLK 6 CT‐1999‐02173</fundingNumber></fundingInfo><fundingInfo><fundingAgency>INSERM</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Royal Society Dorothy Hodgkin Fellowship</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Junior Research Fellowship from St. John's College Cambridge</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>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 (<i>off</i> and <i>on</i> levodopa) and twice 3 months after surgery (OFF and ON STN stimulation, <i>off</i> 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</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Effects of Levodopa and STN Stimulation</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Effects of levodopa and subthalamic nucleus stimulation on cognitive and affective functioning in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Aurélie</namePart><namePart type="family">Funkiewiez</namePart><namePart type="termsOfAddress">MA, PhD</namePart><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation><description>Correspondence: INSERM U610, Pavillon Claude Bernard, Hôpital de la Salpêtrière, 47 Bd de l'Hôpital, 75651 Paris Cedex 13, France</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Claire</namePart><namePart type="family">Ardouin</namePart><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Roshan</namePart><namePart type="family">Cools</namePart><affiliation>Department of Experimental Psychology, University of Cambridge, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Paul</namePart><namePart type="family">Krack</namePart><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Valérie</namePart><namePart type="family">Fraix</namePart><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alina</namePart><namePart type="family">Batir</namePart><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stephan</namePart><namePart type="family">Chabardès</namePart><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alim‐Louis</namePart><namePart type="family">Benabid</namePart><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Trevor W.</namePart><namePart type="family">Robbins</namePart><affiliation>Department of Experimental Psychology, University of Cambridge, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pierre</namePart><namePart type="family">Pollak</namePart><affiliation>Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, and INSERM U318, Joseph Fourier University of Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2006-10</dateIssued><dateCaptured encoding="w3cdtf">2005-03-22</dateCaptured><dateValid encoding="w3cdtf">2005-12-01</dateValid><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">2</extent><extent unit="references">46</extent><extent unit="words">4515</extent></physicalDescription><abstract 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</abstract><note type="funding">Fifth PCRDT - No. QLK 6 CT‐1999‐02173; </note><note type="funding">INSERM</note><note type="funding">Royal Society Dorothy Hodgkin Fellowship</note><note type="funding">Junior Research Fellowship from St. John's College Cambridge</note><subject lang="en"><genre>Keywords</genre><topic>levodopa</topic><topic>subthalamic nucleus stimulation</topic><topic>basal ganglia frontal loops</topic><topic>Parkinson's disease</topic><topic>neuropsychology</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>21</number></detail><detail type="issue"><caption>no.</caption><number>10</number></detail><extent unit="pages"><start>1656</start><end>1662</end><total>7</total></extent></part></relatedItem><identifier type="istex">C251B29A0A62D5658BD6BE76B8576D968157E64B</identifier><identifier type="DOI">10.1002/mds.21029</identifier><identifier type="ArticleID">MDS21029</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2006 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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