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Pallidal Stimulation in Parkinson’s Disease Does Not Induce Apathy
Clément Lozachmeur, M.D.; Sophie Drapier, M.D.; Gabriel Robert, M.D., Ph.D.; Thibaut Dondaine; Bruno Laviolle, M.D., Ph.D.; Paul Sauleau, M.D.; Julie Peron, Ph.D.; Florence Le Jeune, M.D., Ph.D.; David Travers, M.D.; Bruno Millet, M.D., Ph.D.; Marc Vérin, M.D., Ph.D.; Dominique Drapier, M.D., Ph.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;:. doi:10.1176/appi.neuropsych.13020032
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From the Dept. of Psychiatry, Centre Hospitalier Guillaume Régnier, Rennes, France (CL, GR, TD, DD); “Behavior and Basal Ganglia” Host Team (Equipe d’Accueil), University of Rennes ,Rennes, France (CL, SD,GR, TD, PS, JP, FLJ, DT, BM, MV, DD); Dept. of Neurology, Centre Hospitalier Universitaire Pontchaillou, Rennes, France (SD, TD, JP, MV); Dept. of Psychiatry, Centre Hospitalier Universitaire Pontchaillou, Rennes, France (DT, BM; CHU Rennes, Dept. of Clinical Pharmacology, Centre Hospitalier Universitaire Pontchaillou Rennes, France (BL); INSERM, 0203, Clinical Research Center, Centre Hospitalier Universitaire Pontchaillou, Rennes, France (BL); Dept. of Neurophysiology, Centre Hospitalier Universitaire Pontchaillou, Rennes, France (PS); and Dept. of Nuclear Medicine, Eugene Marquis Center, Rennes, France (FLJ).

Send correspondence to Dr. Lozachmeur; e-mail: c.lozachmeur@ch-guillaumeregnier.fr

Copyright © 2014 by the American Psychiatric Association

Received February 21, 2013; Revised May 07, 2013; Accepted May 08, 2014.

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Abstract

Background: Whereas apathy is known as a common consequence of subthalamic nucleus deep brain stimulation in Parkinson’s disease, few studies have investigated the psychiatric consequences of internal globus pallidus deep brain stimulation.

Method: Twenty consecutive parkinsonian patients who underwent bilateral pallidal stimulation were assessed 3 months prior to surgery (M‒3) and at both 3 (M3) and 6 months (M6) after surgery, using psychiatric, neuropsychological, and motor scales. Apathy, mood state, and anxiety state were scored using the Apathy Evaluation Scale, the Montgomery-Åsberg Depression Rating Scale, and the anxiety scale from the Association for Methodology and Documentation in Psychiatry, respectively.

Results: The mean apathy score remained stable between the preoperative M‒3 assessment (37.2±6.2) and both the postoperative M3 (36.9±7.5) and M6 (37.2±5.0) assessments. The mean depression score did not differ between the M‒3 assessment and M3 and M6 assessments. There was no difference between the preoperative mean anxiety score and both the postoperative M3 and M6 scores. The mean score for the Mattis Dementia Rating Scale remained stable at each study visit.

Conclusions: The main result of our study is the absence of deterioration in psychiatric and cognitive scores 3 months and 6 months after pallidal stimulation.

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