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Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson's disease. 总被引:9,自引:0,他引:9
Aurélie Funkiewiez Claire Ardouin Paul Krack Valérie Fraix Nadège Van Blercom Jing Xie Elena Moro Alim-Louis Benabid Pierre Pollak 《Movement disorders》2003,18(5):524-530
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. 相似文献
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Del Prete Eleonora Schmitt Emmanuelle Meoni Sara Fraix Valerie Castrioto Anna Pelissier Pierre Ceravolo Roberto Moro Elena 《Neurological sciences》2022,43(6):3641-3647
Neurological Sciences - In Parkinson’s disease (PD), non-motor fluctuations (NMFs), especially neuropsychiatric fluctuations, often coexist with motor fluctuations (MFs) but are often... 相似文献
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Michael T. Barbe MD Lisa Tonder MS Paul Krack MD PhD Bettina Debû MD Michael Schüpbach MD Steffen Paschen MD Till A. Dembek MD Andrea A. Kühn MD Valerie Fraix MD Christine Brefel-Courbon MD PhD Lars Wojtecki MD PhD David Maltête MD PhD Phillippe Damier MD PhD Friederike Sixel-Döring MD Daniel Weiss MD Marcus Pinsker MD PhD Tatiana Witjas MD PhD Stephane Thobois MD PhD Carmen Schade-Brittinger B.Sc Jörn Rau MSc Jean-Luc Houeto MD PhD Andreas Hartmann MD PhD Lars Timmermann MD PhD Alfons Schnitzler MD PhD Valerie Stoker MPH Marie Vidailhet MD PhD Günther Deuschl MD PhD for the EARLYSTIM study group 《Movement disorders》2020,35(1):82-90
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Effect of subthalamic nucleus stimulation on levodopa-induced dyskinesia in Parkinson's disease 总被引:10,自引:0,他引:10
Article abstract-The authors studied the effect of bilateral subthalamic nucleus stimulation on levodopa-induced dyskinesias in 24 consecutive parkinsonian patients with disabling dyskinesias. The improvement in the three subtypes of levodopa-induced dyskinesias was significant from the third postoperative month and was mainly due to the decrease in the daily dose of levodopa allowed by the stimulation-induced improvement in the motor score. 相似文献
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How much phenotypic variation can be attributed to parkin genotype? 总被引:12,自引:0,他引:12
Lohmann E Periquet M Bonifati V Wood NW De Michele G Bonnet AM Fraix V Broussolle E Horstink MW Vidailhet M Verpillat P Gasser T Nicholl D Teive H Raskin S Rascol O Destée A Ruberg M Gasparini F Meco G Agid Y Durr A Brice A;French Parkinson's Disease Genetics Study Group;European Consortium on Genetic Susceptibility in Parkinson's Disease 《Annals of neurology》2003,54(2):176-185
To establish phenotype-genotype correlations in early-onset parkinsonism, we have compared the phenotype of a large series of 146 patients with and 250 patients without parkin mutations. Although no single sign distinguished the groups, patients with mutations had significantly earlier and more symmetrical onset, dystonia more often at onset and hyperreflexia, slower progression of the disease, and a tendency toward a greater response to levodopa despite lower doses. After forward stepwise multiple logistic regression analysis, dystonia at onset and brisk reflexes were not longer significantly different but were correlated with age at onset rather than the presence of the parkin mutation. Age at onset in carriers of parkin mutations varied as did the rate of progression of the disease: the younger the age at onset the slower the evolution. The genotype influenced the phenotype: carriers of at least one missense mutation had a higher United Parkinson's Disease Rating Scale motor score than those carrying two truncating mutations. The localization of the mutations was also important because missense mutations in functional domains of parkin resulted in earlier onset. Patients with a single heterozygous mutation had significantly later and more asymmetrical onset and more frequent levodopa-induced fluctuations and dystonia than patients with two mutations. 相似文献
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Brown P Marsden J Defebvre L Cassim F Mazzone P Oliviero A Altibrandi MG Di Lazzaro V Limousin-Dowsey P Fraix V Odin P Pollak P 《Neuroreport》2001,12(11):2577-2581
We hypothesised that bradykinesia may be partly due to the failure of the corticomuscular system to engage in high frequency oscillatory activity in Parkinson's disease (PD). In healthy subjects such oscillations are evident in coherence between active muscles at 15--30 Hz. We therefore investigated the effects of therapeutic stimulation of the basal ganglia on this coherence and related it to changes in bradykinesia in the contralateral arm. Increases in coherence at 15--30 Hz and improvements in bradykinesia upon stimulation were correlated (r = 0.564, p < 0.001). This suggests that the basal ganglia modulate oscillatory activity in the corticomuscular system and that impairment of the motor system's ability to engage in synchronised oscillations at high frequency may contribute to bradykinesia in PD. 相似文献
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Ebba Lohmann MD Marie‐Laure Welter MD Valérie Fraix MD Paul Krack MD Suzanne Lesage MD Sophie Laine BS Marie‐Laure Tanguy MD PhD Jean‐Luc Houeto MD Valérie Mesnage MD Pierre Pollak MD Alexandra Durr MD PhD Yves Agid MD PhD Alexis Brice MD French Parkinson's Disease Genetics study group 《Movement disorders》2008,23(5):740-743
Patients with parkin mutations are known to have slower PD progression and a better response to levodopa at lower doses than patients with idiopathic Parkinson's disease. To determine the effects of deep brain stimulation (DBS) on such patients, we have compared the follow‐up after surgery of 7 patients with one parkin mutation, 7 patients with two parkin mutations, and 39 patients without parkin mutations. Twelve to 24 months after neurosurgery, the daily doses of levodopa equivalent were significantly lower in patients with two parkin mutations, indicating that these patients benefit from DBS, and they might have more durable results. © 2008 Movement Disorder Society 相似文献
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Elena Moro Andres M. Lozano Pierre Pollak Yves Agid Stig Rehncrona Jens Volkmann Jaime Kulisevsky Jose A. Obeso Alberto Albanese Marwan I. Hariz Niall P. Quinn Jans D. Speelman Alim L. Benabid Valerie Fraix Alexandre Mendes Marie‐Laure Welter Jean‐Luc Houeto Philippe Cornu Didier Dormont Annalena L. Tornqvist Ron Ekberg Alfons Schnitzler Lars Timmermann Lars Wojtecki Andres Gironell Maria C. Rodriguez‐Oroz Jorge Guridi Anna R. Bentivoglio Maria F. Contarino Luigi Romito Massimo Scerrati Marc Janssens Anthony E. Lang 《Movement disorders》2010,25(5):578-586
We report the 5 to 6 year follow‐up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty‐five STN patients and 16 GPi patients were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross‐over double‐blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off‐ and on‐medication states with and without stimulation, activities of daily living (ADL), anti‐PD medications, and dyskinesias. In double‐blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN, P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with off‐stimulation, regardless of the sequence of stimulation. In open assessment, both STN‐ and GPi‐DBS significantly improved the off‐medication motor UPDRS when compared with before surgery (STN, P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti‐PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long‐term efficacy of STN and GPi DBS in advanced PD. Although the surgical targets were not randomized, there was a trend to a better outcome of motor signs in the STN‐DBS patients and fewer adverse events in the GPi‐DBS group. © 2010 Movement Disorder Society 相似文献
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Kickler N Krack P Fraix V Lebas JF Lamalle L Durif F Krainik A Rémy C Segebarth C Pollak P 《NMR in biomedicine》2007,20(8):757-762
Loss of nigral dopamine neurons in Parkinson's disease induces abnormal activation of glutamate systems in the basal ganglia. The purpose of this study was to assess these changes in the lentiform nucleus using MRS with optimized glutamate sensitivity (TE-averaged method). Ten patients with Parkinson's disease and 10 healthy controls were examined. Compared with healthy controls, no significant differences in glutamate were measured in patients, but a trend to lower total creatine was observed. 相似文献