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Zoon TJ, van Rooijen G, Balm GM, Bergfeld IO, Daams JG, Krack P, Denys DA, de Bie RM. Apathy Induced by Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease: A Meta-Analysis. Mov Disord 2021; 36:317-326. [PMID: 33331023 PMCID: PMC7986158 DOI: 10.1002/mds.28390] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022] Open
Abstract
Apathy, the loss of motivation, is a common problem in Parkinson's disease (PD) and often observed following deep brain stimulation (DBS) of the subthalamic nucleus (STN). The aim of this meta-analysis was to determine the occurrence of apathy following STN DBS in literature. Relevant articles were searched in PubMed/Medline, SCOPUS, EMBASE, and Web of Sciences electronic databases. Studies were included if they reported apathy scores pre- and post-DBS or the cross-sectional difference between PD patients receiving STN DBS and patients receiving medication only. Thirty-three articles were included in the meta-analyses from 6,658 screened articles by two authors independently. A total of 1,286 patients were included with a mean age (±standard deviation [SD]) of 58.4 ± 8.5 years and a disease duration of 11.0 ± 5.8 years. The apathy score measured by means of the Apathy Evaluation Scale (AES), Starkstein Apathy Scale (SAS), and the Lille Apathy Rating Scale (LARS) was significantly higher after DBS than pre-operatively (g = 0.34, 95% confidence interval [CI] = 0.19-0.48, P < 0.001). An equal, significant difference in severity of apathy was found between STN DBS and medication only (g = 0.36, 95% CI = 0.03-0.65; P = 0.004). Statistical heterogeneity was moderately high, but the effects stood strong after multiple analyses and were independent of tapering off dopaminergic medication. The findings of this meta-analysis indicate that apathy is increased after STN DBS compared to the pre-operative state and to medication only (systematic review registration number: PROSPERO CRD42019133932). © 2020 Universiteit van Amsterdam. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Thomas J.C. Zoon
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - Geeske van Rooijen
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - Georgina M.F.C. Balm
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - Isidoor O. Bergfeld
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
- Amsterdam Brain and CognitionAmsterdamthe Netherlands
| | - Joost G. Daams
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - Paul Krack
- Division of Movement Disorder, Department of NeurologyInselspital, University Hospital BernBernSwitzerland
| | - Damiaan A.J.P. Denys
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - Rob M.A. de Bie
- Department of NeurologyAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
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Ehlen F, Al-Fatly B, Kühn AA, Klostermann F. Impact of deep brain stimulation of the subthalamic nucleus on natural language in patients with Parkinson's disease. PLoS One 2020; 15:e0244148. [PMID: 33373418 PMCID: PMC7771859 DOI: 10.1371/journal.pone.0244148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/03/2020] [Indexed: 12/30/2022] Open
Abstract
Background In addition to the typical motor symptoms, a majority of patients suffering from Parkinson’s disease experience language impairments. Deep Brain Stimulation of the subthalamic nucleus robustly reduces motor dysfunction, but its impact on language skills remains ambiguous. Method To elucidate the impact of subthalamic deep brain stimulation on natural language production, we systematically analyzed language samples from fourteen individuals (three female / eleven male, average age 66.43 ± 7.53 years) with Parkinson’s disease in the active (ON) versus inactive (OFF) stimulation condition. Significant ON-OFF differences were considered as stimulation effects. To localize their neuroanatomical origin within the subthalamic nucleus, they were correlated with the volume of tissue activated by therapeutic stimulation. Results Word and clause production speed increased significantly under active stimulation. These enhancements correlated with the volume of tissue activated within the associative part of the subthalamic nucleus, but not with that within the dorsolateral motor part, which again correlated with motor improvement. Language error rates were lower in the ON vs. OFF condition, but did not correlate with electrode localization. No significant changes in further semantic or syntactic language features were detected in the current study. Conclusion The findings point towards a facilitation of executive language functions occurring rather independently from motor improvement. Given the presumed origin of this stimulation effect within the associative part of the subthalamic nucleus, this could be due to co-stimulation of the prefrontal-subthalamic circuit.
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Affiliation(s)
- Felicitas Ehlen
- Department of Neurology, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Jüdisches Krankenhaus Berlin, Berlin, Germany
- * E-mail:
| | - Bassam Al-Fatly
- Department of Neurology, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea A. Kühn
- Department of Neurology, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- Neurocure Cluster of Excellence, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Berlin, Germany
| | - Fabian Klostermann
- Department of Neurology, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
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Arten TLDS, Hamdan AC. Executive Functions in Parkinson's disease with and without Deep Brain Stimulation (DBS): A systematic review. Dement Neuropsychol 2020; 14:178-185. [PMID: 32595888 PMCID: PMC7304270 DOI: 10.1590/1980-57642020dn14-020012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Given the aging of the world population, it is essential to investigate which methods are most effective for treating the diseases that manifest with age. This study addresses Parkinson’s disease (PD), for which Deep Brain Stimulation (DBS) has been increasingly used to treat the disease.
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Duprez J, Houvenaghel JF, Dondaine T, Péron J, Haegelen C, Drapier S, Modolo J, Jannin P, Vérin M, Sauleau P. Subthalamic nucleus local field potentials recordings reveal subtle effects of promised reward during conflict resolution in Parkinson's disease. Neuroimage 2019; 197:232-242. [DOI: 10.1016/j.neuroimage.2019.04.071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/20/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022] Open
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Duprez J, Houvenaghel JF, Argaud S, Naudet F, Robert G, Drapier D, Vérin M, Sauleau P. Impulsive oculomotor action selection in Parkinson's disease. Neuropsychologia 2016; 95:250-258. [PMID: 28039058 DOI: 10.1016/j.neuropsychologia.2016.12.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/23/2016] [Accepted: 12/27/2016] [Indexed: 11/29/2022]
Abstract
The effects of Parkinson's disease (PD) on the dynamics of impulsive action selection and suppression have recently been studied using distributional analyses, but with mixed results, especially for selection. Furthermore, some authors have suggested that impulsivity, regarded as a personality trait, shares common features with behavioral tasks' measures. The current study was designed to clarify the impact of PD on impulsive action selection and suppression, and investigate the link between cognitive action control and self-reported impulsivity. We administered an oculomotor version of the Simon task to 32 patients with PD and 32 matched healthy controls (HC), and conducted distributional analyses in accordance with the activation-suppression model. Patients and HC also filled out the Barratt Impulsiveness Scale (BIS) questionnaire. Results showed that patients with PD were faster overall and exhibited a greater congruence effect than HC. They also displayed enhanced impulsive action selection. By contrast, the suppression of impulsive responses was similar across both groups. Furthermore, patients had higher impulsivity scores, which were correlated with higher impulsive action selection and higher suppression. Our study yielded two interesting findings. First, PD resulted in a higher number of fast errors. The activation-suppression model suggests that patients with PD are more susceptible to the impulsive action selection induced by the irrelevant stimulus dimension. Second, impulsive action selection and suppression were both associated with trait impulsivity, as measured by the BIS, indicating that these two aspects of impulsivity share common features.
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Affiliation(s)
- Joan Duprez
- "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue du Professeur Léon Bernard, 35000 Rennes, France.
| | - Jean-François Houvenaghel
- "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue du Professeur Léon Bernard, 35000 Rennes, France; Department of Neurology, Rennes University Hospital, Rue Henri Le Guilloux, 35033 Rennes, France
| | - Soizic Argaud
- "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue du Professeur Léon Bernard, 35000 Rennes, France; "Neuroscience of Emotion and Affective Dynamics" Lab, Swiss Center for Affective Sciences, 40 boulevard du Pont d'Arve, 1205 Geneva, Switzerland
| | - Florian Naudet
- "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue du Professeur Léon Bernard, 35000 Rennes, France; Department of Psychiatry, Rennes University Hospital, 108 Avenue du Général Leclerc, 35703 Rennes, France; Clinical Investigation Center (INSERM 0203), Department of Pharmacology, Rennes University Hospital, Rue Henri Le Guilloux, 35033 Rennes, France
| | - Gabriel Robert
- "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue du Professeur Léon Bernard, 35000 Rennes, France; Department of Psychiatry, Rennes University Hospital, 108 Avenue du Général Leclerc, 35703 Rennes, France
| | - Dominique Drapier
- "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue du Professeur Léon Bernard, 35000 Rennes, France; Department of Psychiatry, Rennes University Hospital, 108 Avenue du Général Leclerc, 35703 Rennes, France
| | - Marc Vérin
- "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue du Professeur Léon Bernard, 35000 Rennes, France; Department of Neurology, Rennes University Hospital, Rue Henri Le Guilloux, 35033 Rennes, France
| | - Paul Sauleau
- "Behavior and Basal Ganglia" research unit (EA 4712), University of Rennes 1, Avenue du Professeur Léon Bernard, 35000 Rennes, France; Department of Neurophysiology, Rennes University Hospital, Rue Henri Le Guilloux, 35033 Rennes, France
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