Apathy and verbal fluency in STN-stimulated PD patients

Castelli, Lorys; Lanotte, Michele; Zibetti, Maurizio; Caglio, Marcella Maria; Rizzi, Laura; Ducati, Alessandro; Bergamasco, B.; Lopiano, Leonardo

doi:10.1007/s00415-006-0510-7

Cited by 58 publications

(58 citation statements)

References 28 publications

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“…However, when looking into subitems, the incidence of sialorrhea and dysarthria were significantly higher in the GA group. A decline in semantic and verbal fluency, color naming selective attention, and verbal memory in PD patients after STN-DBS can be interpreted as an impairment of executive function that results from a neural connection to the frontal cortex [29][30][31] . This impairment may have a meaningful effect on the patient's daily life.…”

Section: Discussionmentioning

confidence: 99%

Subthalamic Deep Brain Stimulation in Parkinson’s Disease under Different Anesthetic Modalities: A Comparative Cohort Study

Chen¹,

Tsai²,

Lin³

et al. 2011

Stereotact Funct Neurosurg

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Background: The efficacy and feasibility of bilateral subthalamic deep brain stimulation (STN-DBS) for Parkinson’s disease (PD) under general anesthesia (GA) has not been evaluated. Objective: We compared the outcome of patients under GA with those who were operated on under local anesthesia (LA). Material and Methods: Thirty-three patients were assigned to the GA group (desflurane) and 19 patients were assigned to the LA group. Microelectrode recording (MER) was performed in both groups. The surgical outcomes of the patients were evaluated using the Unified Parkinson’s Disease Rating Scale (UPDRS) after at least 12 months after surgery. Results: Postoperatively, there was no significant difference on the UPDRS scores in either groups. A significant deterioration in cognitive function in the GA group was observed (p = 0.017). The recorded electrode coordinates, the average tracts for the MER, and STN depth were comparable in both groups. The overall incidence of adverse effects did not show any difference except that the incidence of sialorrhea and dysarthria was significantly higher in the GA group. Conclusion: Desflurane GA was shown to be a good alternative anesthetic method for PD patients undergoing DBS. Although the motor outcomes were comparable, a significant cognitive decline may be seen in the GA group with a higher occurrence of stimulation side effects.

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Section: Discussionmentioning

confidence: 99%

Subthalamic Deep Brain Stimulation in Parkinson’s Disease under Different Anesthetic Modalities: A Comparative Cohort Study

Chen¹,

Tsai²,

Lin³

et al. 2011

Stereotact Funct Neurosurg

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“…As an integral part of the hyperdirect and indirect pathways, the STN is well-placed to influence a range of behaviours, although evidence for the effect of STN DBS on motivational aspects of behaviour has been so far conflicting. It has been reported that STN stimulation induces or worsens apathy (Gervais-Bernard, et al, 2009;Krack, et al, 2003;Saint-Cyr, Trepanier, Kumar, Lozano, & Lang, 2000), while others found no effect or even improvement of apathy following STN DBS surgery (Castelli, et al, 2007;Czernecki, et al, 2005;Schuepbach, et al, 2013). Similarly, STN DBS has been linked with post-surgical de novo emergence of pathological gambling or shopping, but also with improvement of impulse control disorders (Amami, et al, 2015;Demetriades, Rickards, & Cavanna, 2011;Lim, et al, 2009;Moum, et al, 2012).…”

Section: Resultsmentioning

confidence: 99%

In Parkinson’s disease STN stimulation enhances responsiveness of movement initiation speed to high reward value

2016

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“…It has been proven that DBS suppresses motor symptoms and reduces the total dose of the antiparkinsonian drugs 2,3 . Among the adverse effects of STN-DBS in patients with PD, the postoperative decline in verbal fluency is well documented 4,5,6,7,8,9,10,11 . However, there are fewer studies about the effect of the stimulation per se, comparing on-and off-stimulation conditions 12,13,14 .…”

Section: Subthalamic Nucleus Deep Brain Stimulation (Stn-dbs)mentioning

confidence: 99%

“…Also, the majority of previous studies pointed to a negative effect of STN-DBS on verbal fluency when they studied postsurgical patients 22 . Some of the studies on pre-and post-DBS have found a decline in phonemic fluency 5,7,10 , others a decline in semantic fluency 6 and still others in both verbal fluency tasks 4,8,9 .…”

Section: Variable M (Sd) or N (%)mentioning

confidence: 99%

Different outcomes of phonemic verbal fluency in Parkinson’s disease patients with subthalamic nucleus deep brain stimulation

Romann

Beber

Olchik

et al. 2017

Arq. Neuro-Psiquiatr.

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Subthalamic nucleus deep brain stimulation (STN-DBS) is a surgical technique to treat motor symptoms in patients withParkinson's disease (PD). Studies have shown that STN-DBS may cause a decline in verbal fluency performance. We aimed to verify the effects of STN-DBS on the performance of phonemic verbal fluency in Brazilian PD patients. Sixteen participants were evaluated on the Unified Parkinson's Disease Rating Scale -Part III and for phonemic fluency ("FAS" version) in the conditions of on-and off-stimulation. We identified two different patterns of phonemic verbal fluency outcomes. The results indicate that there may be no expected pattern of effect of bilateral STN-DBS in the phonemic fluency, and patients may present with different outcomes for some reason not well understood.Keywords: Parkinson disease; deep brain stimulation; language; cognition. RESUMOA estimulação cerebral profunda do núcleo subtalâmico (ECP-NST) é uma técnica cirúrgica para tratar sintomas motores na doença de Parkinson (DP). Estudos têm mostrado que ECP-NST pode causar um declínio no desempenho de fluência verbal. O objetivo do estudo foi verificar os efeitos da ECP-NST sobre o desempenho da fluência verbal fonêmica em indivíduos brasileiros com DP. Dezesseis participantes foram avaliados quanto ao desempenho motor (UPDRS-III) e à fluência verbal fonêmica (versão "FAS") nas condições de estimulação ligada e desligada. Identificamos dois padrões diferentes de resultados de fluência verbal fonêmica. Os resultados indicam que pode não haver um padrão esperado de efeito de ECP-NST bilateral na fluência fonêmica, e os pacientes podem apresentar desfechos diferentes de acordo com alguma razão não bem compreendida.Palavras-chave: doença de Parkinson; estimulação encefálica profunda; linguagem; cognição. Subthalamic nucleus deep brain stimulation (STN-DBS)is a procedure used to treat patients with Parkinson's disease (PD) when pharmacological treatment is no longer efficient 1 . It has been proven that DBS suppresses motor symptoms and reduces the total dose of the antiparkinsonian drugs 2,3 . Among the adverse effects of STN-DBS in patients with PD, the postoperative decline in verbal fluency is well documented 4,5,6,7,8,9,10,11 . However, there are fewer studies about the effect of the stimulation per se, comparing on-and off-stimulation conditions 12,13,14 . Longitudinal studies verified a worsening of verbal fluency in the first months after surgery, but an improvement in the later studied months 9 . These authors suggest that this effect of the DBS on the verbal fluency may be due to the micro-lesions caused by the implantation procedure of the electrodes in the STN.The verbal fluency test evaluates the capacity to search and retrieve data stored in long-term memory within a certain category and demonstrates the capacities of

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Apathy and verbal fluency in STN-stimulated PD patients

Abstract: The results of the present study suggest that DBS of STN does not necessarily induce apathy even if individual patients show a moderate post-operative worsening of apathetic symptoms.

Cited by 58 publications

References 28 publications

Subthalamic Deep Brain Stimulation in Parkinson’s Disease under Different Anesthetic Modalities: A Comparative Cohort Study

Subthalamic Deep Brain Stimulation in Parkinson’s Disease under Different Anesthetic Modalities: A Comparative Cohort Study

In Parkinson’s disease STN stimulation enhances responsiveness of movement initiation speed to high reward value

Different outcomes of phonemic verbal fluency in Parkinson’s disease patients with subthalamic nucleus deep brain stimulation

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