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Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease.
Mov Disord. 2003 May; 18(5):524-30.MD

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.

Authors+Show Affiliations

Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12722166

Citation

Funkiewiez, Aurélie, et al. "Acute Psychotropic Effects of Bilateral Subthalamic Nucleus Stimulation and Levodopa in Parkinson's Disease." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 18, no. 5, 2003, pp. 524-30.
Funkiewiez A, Ardouin C, Krack P, et al. Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease. Mov Disord. 2003;18(5):524-30.
Funkiewiez, A., Ardouin, C., Krack, P., Fraix, V., Van Blercom, N., Xie, J., Moro, E., Benabid, A. L., & Pollak, P. (2003). Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease. Movement Disorders : Official Journal of the Movement Disorder Society, 18(5), 524-30.
Funkiewiez A, et al. Acute Psychotropic Effects of Bilateral Subthalamic Nucleus Stimulation and Levodopa in Parkinson's Disease. Mov Disord. 2003;18(5):524-30. PubMed PMID: 12722166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease. AU - Funkiewiez,Aurélie, AU - Ardouin,Claire, AU - Krack,Paul, AU - Fraix,Valérie, AU - Van Blercom,Nadège, AU - Xie,Jing, AU - Moro,Elena, AU - Benabid,Alim-Louis, AU - Pollak,Pierre, PY - 2003/5/2/pubmed PY - 2003/9/18/medline PY - 2003/5/2/entrez SP - 524 EP - 30 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 18 IS - 5 N2 - 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. SN - 0885-3185 UR - https://www.unboundmedicine.com/medline/citation/12722166/Acute_psychotropic_effects_of_bilateral_subthalamic_nucleus_stimulation_and_levodopa_in_Parkinson's_disease_ L2 - https://doi.org/10.1002/mds.10441 DB - PRIME DP - Unbound Medicine ER -