Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug;89(8):836-843.
doi: 10.1136/jnnp-2017-316373. Epub 2018 Feb 7.

Subthalamic stimulation and neuropsychiatric symptoms in Parkinson's disease: results from a long-term follow-up cohort study

Marie Abbes #  1 , Eugénie Lhommée #  1   2   3 , Stéphane Thobois  4   5   6 , Hélène Klinger  4   5   6 , Emmanuelle Schmitt  1   2   3 , Amélie Bichon  1   2   3 , Anna Castrioto  1   2   3 , Jing Xie  7 , Valérie Fraix  1   2   3 , Andrea Kistner  1   2   3 , Pierre Pélissier  1   2   3 , Éric Seigneuret  8 , Stéphan Chabardès  2   3   8 , Patrick Mertens  9 , Emmanuel Broussolle  4   5   6 , Elena Moro  1   2   3 , Paul Krack  1   2   3   10
Affiliations

Subthalamic stimulation and neuropsychiatric symptoms in Parkinson's disease: results from a long-term follow-up cohort study

Marie Abbes et al. J Neurol Neurosurg Psychiatry. 2018 Aug.

Abstract

Background: Reports on behavioural outcomes after subthalamic nucleus deep brain stimulation in Parkinson's disease are controversial and limited to short-term data. Long-term observation in a large cohort allows a better counselling and management.

Methods: To determine whether a long-term treatment with subthalamic stimulation induces or reduces impulse control behaviours, neuropsychiatric fluctuations and apathy, 69 patients treated with subthalamic stimulation are prospectively and retrospectively assessed using Ardouin Scale of Behavior in Parkinson's Disease before and after 3-10 years of stimulation.

Results: At a mean follow-up of 6 years, all impulse control disorders and dopaminergic addiction were significantly decreased, apart from eating behaviour and hypersexuality. Neuropsychiatric fluctuations also significantly improved (ON euphoria: 38% of the patients before surgery and 1% after surgery, P<0.01; OFF dysphoria: 39% of the patients before surgery and 10% after surgery, P<0.01). However, apathy increased (25% of the patients after surgery and 3% before, P<0.01). With the retrospective analysis, several transient episodes of depression, apathy, anxiety and impulse control disorders occurred.

Conclusions: Bilateral subthalamic nucleus stimulation was overall very effective in improving impulse control disorders and neuropsychiatric fluctuations in parkinsonian patients in the long term despite a counteracting frequent apathy. Transient episodes of impulse control disorders still occurred within the follow-up. These findings recommend a close follow-up in parkinsonian patients presenting with neuropsychiatric symptoms before deep brain stimulation surgery.

Clinical trial registration: NCT01705418;Post-results.

Keywords: Parkinson’s disease; apathy; dopamine; impulse control disorder; subthalamic nucleus.

PubMed Disclaimer

Conflict of interest statement

Competing interests: ST has received grant from Fondation pour la Recherche Médicale, France Parkinson, and ANR; honoraria, travel grant from Boston, Medtronic, Teva, UCB, AbbVie and Aguettant. AC has received granted funds from Edmond J & Lily Safra Foundation; reimbursement of travel expenses to scientific meetings from Orkyn, Elivie, AbbVie, Medtronic and Boston Scientific. VF has received travel grants from Zambon and AbbVie (World PD congress and MD congress); honoraria from UCB, Medtronic for lecturing; honoraria from AbbVie for participation in scientific committee. JX recieved honoraria and travel grant from Teva, UCB and Aguettant. EL received travel grant from Medtronic. EB reports financial support during the past year outside the submitted work from AbbVie (travel expenses, congress registration, consultant), Medtronic (technical support in our hospital for improving DBS therapy and care of patients with movement disorders), Aguettant (consultant and research project) and public financial support from Agence Régionale de Santé Auvergne et Rhône-Alpes (research project on Parkinson’s disease). HK received reimbursement of registration fees and travel expenses to participate in training session from Medtronic. SC received consultancy fees from Medtronic and Boston Scientific and travel reimbursement from Medtronic and Boston Scientific. ES received travel and congress fees from Medtronic, St Jude and Boston Scientific. PK reports grants from the French Ministry of Health (PHRC Programme de Recherche Hospitalier Clinique Interrégional), and Euthérapie during the conduct of the study; grants and personal fees from Medtronic, Boston Scientific, Movement Disorder Society, UCB; grants from St Jude Medical France, Edmond J & Lily Safra Foundation, INSERM (French National Institute of Health and Research in Medicine), France Parkinson, Swiss National Science Foundation, ROGER DE SPOELBERCH Foundation, Centre National Recherche Scientifique, Orkyn, Homeperf; personal fees from European Society Stereotactic Functional Neurosurgery, outside the submitted work. PM received consultancy fees from Medtronic and congress fees and travel reimbursements from Medtronic and St Jude companies. EM has received honoraria from Medtronic for lecturing and scientific board services. She has also received grant support from Merz.

Publication types

Associated data