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Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease

Funkiewiez, Aurélie
Ardouin, Claire
Fraix, Valérie
Van Blercom, Nadège
Xie, Jing
Moro, Elena
Benabid, Alim-Louis
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Published in Movement Disorders. 2003, vol. 18, no. 5, p. 524-30
Abstract High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves the motor symptoms of Parkinson's disease (PD). Opposite changes in mood, such as mania or depression, have been reported after surgery, but it is not known whether these side effects are specifically related to STN DBS. To learn whether STN DBS also influences the limbic loop, we investigated acute subjective psychotropic effects related to levodopa or bilateral STN DBS. After a median postoperative follow-up of 12 months, 50 PD patients completed the Addiction Research Center Inventory (ARCI), assessing subjective psychotropic effects in four conditions: off-drug/on-stimulation; off-drug/off-stimulation; on-drug/off-stimulation; and on-drug/on-stimulation. Both levodopa and STN DBS improved all the ARCI subscales, indicating subjective feelings of well being, euphoria, increase in motivation, and decrease in fatigue, anxiety, and tension. A suprathreshold dose of levodopa was significantly more effective than STN DBS, using the same electrical parameters as for chronic stimulation, on four of the five ARCI subscales. We concluded that 1) both STN DBS and levodopa have synergistic acute beneficial psychotropic effects in PD, 2) the psychotropic effects of both treatments need to be considered in the long-term management of chronic STN DBS, and 3) the results indicate an involvement of the limbic STN in mood disorders of PD.
Keywords Activities of Daily LivingAgedAntiparkinson Agents/administration & dosage/therapeutic useCognition Disorders/diagnosis/physiopathologyDepressive Disorder, Major/diagnosisElectric Stimulation Therapy/instrumentationFemaleFrontal Lobe/physiopathologyFunctional LateralityHumansLevodopa/administration & dosage/therapeutic useMaleMiddle AgedNeuropsychological TestsParkinson Disease/drug therapy/psychology/therapyPsychological TestsPsychomotor Disorders/diagnosisSeverity of Illness IndexSubthalamic Nucleus/physiologySurveys and QuestionnairesTime
PMID: 12722166
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Research group Groupe Pierre Burkhard (neurologie) (154)
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FUNKIEWIEZ, Aurélie et al. Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease. In: Movement Disorders, 2003, vol. 18, n° 5, p. 524-30.

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Deposited on : 2017-06-02

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