1
|
Wirth T, Goetsch T, Corvol JC, Roze E, Mariani LL, Vidailhet M, Grabli D, Mallet L, Pelissolo A, Rascol O, Brefel-Courbon C, Ory-Magne F, Arbus C, Bekadar S, Krystkowiak P, Marques A, Llorca M, Krack P, Castrioto A, Fraix V, Maltete D, Defebvre L, Kreisler A, Houeto JL, Tranchant C, Meyer N, Anheim M. Prognosis of impulse control disorders in Parkinson's disease: a prospective controlled study. J Neurol 2024; 271:2412-2422. [PMID: 38214756 DOI: 10.1007/s00415-023-12170-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The long-term prognosis of impulsive compulsive disorders (ICD) remains poorly studied in Parkinson's disease (PD). OBJECTIVE Evaluating the natural history of ICD and its impact on PD symptoms including cognition and treatment adjustments. MATERIALS AND METHODS We assessed PD patients at baseline (BL) with (BL-ICD+) or without (BL-ICD-) ICD despite dopamine agonist (DA) exposure of > 300 mg levodopa-equivalent daily dose for > 12 months at baseline and after more than two years of follow-up. ICD were assessed using the Ardouin's Scale of Behaviors in PD (ASBPD), cognition using the Mattis scale, and PD symptoms using the UPDRS score. Treatment adjustments, DA withdrawal-associated symptoms, and ICDs social consequences were recorded. RESULTS 149 patients were included (78 cases and 71 controls), mean duration of follow-up was 4.4 ± 1 years. At baseline, psychiatric disorders were more common among BL-ICD + (42.3 vs 12.3% among BL-ICD-, p < 0.01). At follow-up, 53.8% of BL-ICD + were not ICD-free while 21.1% of BL-ICD- had developed ICD. BL-ICD + more frequently experienced akinesia (21.8 vs 8.5%, p = 0.043) and rigidity worsening (11.5 vs 1.4%, p = 0.019) following therapeutic modifications. Decision to decrease > 50% DA doses (12.8 vs 1.4%, p = 0.019) or to withdraw DA (19.2 vs 5.6%, p = 0.025) was more frequently considered among BL-ICD+ . At follow-up, the prevalence of cognitive decline was lower among BL-ICD + (19.2 vs 37.1%, p = 0.025). CONCLUSION ICDs were associated with increased psychiatric burden at baseline and better cognitive prognosis. Most patients were still showing ICDs at the follow-up visit, suggesting ICD to be considered as a chronic, neuropsychiatric disorder.
Collapse
Affiliation(s)
- Thomas Wirth
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 67098, Strasbourg, France.
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch-Graffenstaden, France.
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France.
| | - Thibaut Goetsch
- Service de santé Publique, GMRC, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jean-Christophe Corvol
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Emmanuel Roze
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Louise-Laure Mariani
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Marie Vidailhet
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - David Grabli
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Luc Mallet
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
- Department of Mental Health and Psychiatry, University of Geneva, Geneva, Switzerland
| | - Antoine Pelissolo
- INSERM U955, Laboratoire Neuro-Psychiatrie Translationnelle, Créteil, France
- AP-HP, DMU IMPACT, Service de Psychiatrie, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | - Olivier Rascol
- Service de neurologie B8, CHU Toulouse, Toulouse, France
- Centre d'investigations Clinique, CHU Toulouse, Toulouse, France
| | | | | | - Christophe Arbus
- Pôle de psychiatrie, Universitaire, CHU de Toulouse, Université Paul Sabatier Toulouse, Toulouse, France
| | - Samir Bekadar
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Pierre Krystkowiak
- Service de Neurologie, Centre Hospitalo-Universitaire d'Amiens, Amiens, France
| | - Ana Marques
- CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Michel Llorca
- Service de Psychiatrie, Centre Hospitalo-universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Anna Castrioto
- Neurology Department, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, University Grenoble Alpes, 38000, Grenoble, France
| | - Valérie Fraix
- Neurology Department, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, University Grenoble Alpes, 38000, Grenoble, France
| | - David Maltete
- Service de Neurologie, Centre Hospitalier Universitaire, Rouen, France
| | - Luc Defebvre
- Neurologie and Pathologie du Mouvement, CHU de Lille, Lille, France
| | | | | | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 67098, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch-Graffenstaden, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Nicolas Meyer
- Service de santé Publique, GMRC, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 67098, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch-Graffenstaden, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| |
Collapse
|
2
|
Ferini-Strambi L, Liguori C, Lucey BP, Mander BA, Spira AP, Videnovic A, Baumann C, Franco O, Fernandes M, Gnarra O, Krack P, Manconi M, Noain D, Saxena S, Kallweit U, Randerath W, Trenkwalder C, Rosenzweig I, Iranzo A, Bradicich M, Bassetti C. Correction to: Role of sleep in neurodegeneration: the consensus report of the 5th Think Tank World Sleep Forum. Neurol Sci 2024; 45:1813. [PMID: 38326667 DOI: 10.1007/s10072-024-07391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Affiliation(s)
- Luigi Ferini-Strambi
- Sleep Disorders Center, Division of Neuroscience, Università Vita-Salute San Raffaele, Milan, Italy.
| | - Claudio Liguori
- Sleep Medicine Center, University of Rome Tor Vergata, Rome, Italy
| | - Brendan P Lucey
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aleksandar Videnovic
- Department of Neurology, Division of Sleep Medicine, Massachussets General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christian Baumann
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Oscar Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Oriella Gnarra
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Mauro Manconi
- Sleep Medicine Unit, Faculty of Biomedical Sciences, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Daniela Noain
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Smita Saxena
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Ulf Kallweit
- Clinical Sleep and Neuroimmunology, University Witten/Herdecke, Witten, Germany
| | | | - C Trenkwalder
- Department of Neurosurgery, Paracelsus-Elena Klinik, University Medical Center, KasselGoettingen, Germany
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, King's College London, London, UK
| | - Alex Iranzo
- Sleep Center, Neurology Service, Hospital Clinic de Barcelona, Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Matteo Bradicich
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland
| | | |
Collapse
|
3
|
Sousa M, Maamari B, Bremova T, Nuoffer JM, Wiest R, Amstutz D, Krack P, Bartholdi D, Tinkhauser G. Late adult-onset Niemann Pick type C (NPC): An "atypical" typical presentation at the age of 62. Parkinsonism Relat Disord 2024; 120:105460. [PMID: 37355399 DOI: 10.1016/j.parkreldis.2023.105460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 06/26/2023]
Affiliation(s)
- M Sousa
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland
| | - B Maamari
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - T Bremova
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Center for Rare Disorders, Institute of Clinical Chemistry Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - J M Nuoffer
- Center for Rare Disorders, Institute of Clinical Chemistry Inselspital, Bern University Hospital, University of Bern, Switzerland; University Children's Hospital Pediatric Endocrinology, Diabetology and Metabolism, Bern, Switzerland
| | - R Wiest
- Department of Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - D Amstutz
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland
| | - P Krack
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - D Bartholdi
- Department of Human Genetics, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - G Tinkhauser
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
| |
Collapse
|
4
|
Single M, Bruhin LC, Colombo A, Möri K, Gerber SM, Lahr J, Krack P, Klöppel S, Müri RM, Mosimann UP, Nef T. A Transferable Lidar-Based Method to Conduct Contactless Assessments of Gait Parameters in Diverse Home-like Environments. Sensors (Basel) 2024; 24:1172. [PMID: 38400329 PMCID: PMC10893300 DOI: 10.3390/s24041172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
Gait abnormalities in older adults are linked to increased risks of falls, institutionalization, and mortality, necessitating accurate and frequent gait assessments beyond traditional clinical settings. Current methods, such as pressure-sensitive walkways, often lack the continuous natural environment monitoring needed to understand an individual's gait fully during their daily activities. To address this gap, we present a Lidar-based method capable of unobtrusively and continuously tracking human leg movements in diverse home-like environments, aiming to match the accuracy of a clinical reference measurement system. We developed a calibration-free step extraction algorithm based on mathematical morphology to realize Lidar-based gait analysis. Clinical gait parameters of 45 healthy individuals were measured using Lidar and reference systems (a pressure-sensitive walkway and a video recording system). Each participant participated in three predefined ambulation experiments by walking over the walkway. We observed linear relationships with strong positive correlations (R2>0.9) between the values of the gait parameters (step and stride length, step and stride time, cadence, and velocity) measured with the Lidar sensors and the pressure-sensitive walkway reference system. Moreover, the lower and upper 95% confidence intervals of all gait parameters were tight. The proposed algorithm can accurately derive gait parameters from Lidar data captured in home-like environments, with a performance not significantly less accurate than clinical reference systems.
Collapse
Affiliation(s)
- Michael Single
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3012 Bern, Switzerland; (M.S.); (L.C.B.); (A.C.); (K.M.); (S.M.G.); (R.M.M.); (U.P.M.)
| | - Lena C. Bruhin
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3012 Bern, Switzerland; (M.S.); (L.C.B.); (A.C.); (K.M.); (S.M.G.); (R.M.M.); (U.P.M.)
| | - Aaron Colombo
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3012 Bern, Switzerland; (M.S.); (L.C.B.); (A.C.); (K.M.); (S.M.G.); (R.M.M.); (U.P.M.)
| | - Kevin Möri
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3012 Bern, Switzerland; (M.S.); (L.C.B.); (A.C.); (K.M.); (S.M.G.); (R.M.M.); (U.P.M.)
| | - Stephan M. Gerber
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3012 Bern, Switzerland; (M.S.); (L.C.B.); (A.C.); (K.M.); (S.M.G.); (R.M.M.); (U.P.M.)
| | - Jacob Lahr
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland; (J.L.); (S.K.)
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, 3012 Bern, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland; (J.L.); (S.K.)
| | - René M. Müri
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3012 Bern, Switzerland; (M.S.); (L.C.B.); (A.C.); (K.M.); (S.M.G.); (R.M.M.); (U.P.M.)
| | - Urs P. Mosimann
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3012 Bern, Switzerland; (M.S.); (L.C.B.); (A.C.); (K.M.); (S.M.G.); (R.M.M.); (U.P.M.)
| | - Tobias Nef
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3012 Bern, Switzerland; (M.S.); (L.C.B.); (A.C.); (K.M.); (S.M.G.); (R.M.M.); (U.P.M.)
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, 3012 Bern, Switzerland
| |
Collapse
|
5
|
Ferini-Strambi L, Liguori C, Lucey BP, Mander BA, Spira AP, Videnovic A, Baumann C, Franco O, Fernandes M, Gnarra O, Krack P, Manconi M, Noain D, Saxena S, Kallweit U, Randerath W, Trenkwalder C, Rosenzweig I, Iranzo A, Bradicich M, Bassetti C. Role of sleep in neurodegeneration: the consensus report of the 5th Think Tank World Sleep Forum. Neurol Sci 2024; 45:749-767. [PMID: 38087143 DOI: 10.1007/s10072-023-07232-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/26/2023] [Indexed: 01/18/2024]
Abstract
Sleep abnormalities may represent an independent risk factor for neurodegeneration. An international expert group convened in 2021 to discuss the state-of-the-science in this domain. The present article summarizes the presentations and discussions concerning the importance of a strategy for studying sleep- and circadian-related interventions for early detection and prevention of neurodegenerative diseases. An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years; discussed the current challenges in the field of relationships among sleep, sleep disorders, and neurodegeneration; and identified future priorities. Sleep efficiency and slow wave activity during non-rapid eye movement (NREM) sleep are decreased in cognitively normal middle-aged and older adults with Alzheimer's disease (AD) pathology. Sleep deprivation increases amyloid-β (Aβ) concentrations in the interstitial fluid of experimental animal models and in cerebrospinal fluid in humans, while increased sleep decreases Aβ. Obstructive sleep apnea (OSA) is a risk factor for dementia. Studies indicate that positive airway pressure (PAP) treatment should be started in patients with mild cognitive impairment or AD and comorbid OSA. Identification of other measures of nocturnal hypoxia and sleep fragmentation could better clarify the role of OSA as a risk factor for neurodegeneration. Concerning REM sleep behavior disorder (RBD), it will be crucial to identify the subset of RBD patients who will convert to a specific neurodegenerative disorder. Circadian sleep-wake rhythm disorders (CSWRD) are strong predictors of caregiver stress and institutionalization, but the absence of recommendations or consensus statements must be considered. Future priorities include to develop and validate existing and novel comprehensive assessments of CSWRD in patients with/at risk for dementia. Strategies for studying sleep-circadian-related interventions for early detection/prevention of neurodegenerative diseases are required. CSWRD evaluation may help to identify additional biomarkers for phenotyping and personalizing treatment of neurodegeneration.
Collapse
Affiliation(s)
- Luigi Ferini-Strambi
- Sleep Disorders Center, Division of Neuroscience, Università Vita-Salute San Raffaele, Milan, Italy.
| | - Claudio Liguori
- Sleep Medicine Center, University of Rome Tor Vergata, Rome, Italy
| | - Brendan P Lucey
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aleksandar Videnovic
- Department of Neurology, Division of Sleep Medicine, Massachussets General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christian Baumann
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Oscar Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Oriella Gnarra
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Mauro Manconi
- Sleep Medicine Unit, Faculty of Biomedical Sciences, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Daniela Noain
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Smita Saxena
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Ulf Kallweit
- Clinical Sleep and Neuroimmunology, University Witten/Herdecke, Witten, Germany
| | | | - C Trenkwalder
- Department of Neurosurgery, Paracelsus-Elena Klinik, University Medical Center, KasselGoettingen, Germany
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, King's College London, London, UK
| | - Alex Iranzo
- Sleep Center, Neurology Service, Hospital Clinic de Barcelona, Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Matteo Bradicich
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland
| | | |
Collapse
|
6
|
Debove I, Paschen S, Amstutz D, Cardoso F, Corvol JC, Fung VSC, Lang AE, Martinez Martin P, Rodríguez-Oroz MC, Weintraub D, Krack P, Deuschl G. Management of Impulse Control and Related Disorders in Parkinson's Disease: An Expert Consensus. Mov Disord 2024; 39:235-248. [PMID: 38234035 DOI: 10.1002/mds.29700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/23/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Impulse-control and related behavioral disorders (ICBDs) significantly impact the lives of Parkinson's disease (PD) patients and caregivers, with lasting consequences if undiagnosed and untreated. While ICBD pathophysiology and risk factors are well-studied, a standardized severity definition and treatment evidence remain elusive. OBJECTIVE This work aimed to establish international expert consensus on ICBD treatment strategies. To comprehensively address diverse treatment availabilities, experts from various continents were included. METHODS From 2021 to 2023, global movement disorders specialists engaged in a Delphi process. A core expert group initiated surveys, involving a larger panel in three iterations, leading to refined severity definitions and treatment pathways. RESULTS Experts achieved consensus on defining ICBD severity, emphasizing regular PD patient screenings for early detection. General treatment recommendations focused on continuous monitoring, collaboration with significant others, and seeking specialist advice for legal or financial challenges. For mild to severe ICBDs, gradual reduction in dopamine agonists was endorsed, followed by reductions in other PD medications. Second-line treatment strategies included diverse approaches like reversing the last medication change, cognitive behavior therapy, subthalamic nucleus deep brain stimulation, and specific medications like quetiapine, clozapine, and antidepressants. The panel reached consensus on distinct treatment pathways for punding and dopamine dysregulation syndrome, formulating therapy recommendations. Comprehensive discussions addressed management strategies for the exacerbation of either motor or non-motor symptoms following the proposed treatments. CONCLUSION The consensus offers in-depth insights into ICBD management, presenting clear severity criteria and expert consensus treatment recommendations. The study highlights the critical need for further research to enhance ICBD management. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Ines Debove
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Steffen Paschen
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Deborah Amstutz
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Francisco Cardoso
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, The Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Jean-Christophe Corvol
- Department of Neurology, Sorbonne Université, Paris Brain Institute (ICM), Inserm, CNRS, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Victor S C Fung
- Movement Disorders Unit, Department of Neurology, Westmead Hospital and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Anthony E Lang
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Pablo Martinez Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | | | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Parkinson's Disease Research, Education and Clinical Center (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| |
Collapse
|
7
|
Magalhães AD, Amstutz D, Petermann K, Debove I, Sousa M, Maradan-Gachet ME, Lachenmayer ML, Waskönig J, Murcia-Carretero S, Diamantaras AA, Tinkhauser G, Nowacki A, Pollo C, Rodriguez-Blazquez C, Martinez-Martin P, Krack P. Subthalamic stimulation has acute psychotropic effects and improves neuropsychiatric fluctuations in Parkinson's disease. BMJ Neurol Open 2024; 6:e000524. [PMID: 38196982 PMCID: PMC10773312 DOI: 10.1136/bmjno-2023-000524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 01/11/2024] Open
Abstract
Background Subthalamic nucleus deep brain stimulation (STN-DBS) is a well-established treatment for motor complications in Parkinson's disease (PD). However, its effects on neuropsychiatric symptoms remain disputed. The aim of this study was to evaluate the effects of STN-DBS on neuropsychiatric symptoms in PD. Methods We retrospectively assessed 26 patients with PD who underwent a preoperative levodopa challenge and postoperative levodopa and stimulation challenges 1 year after STN-DBS. Based on the Neuropsychiatric Fluctuations Scale, Neuropsychiatric State Scores and Neuropsychiatric Fluctuation Indices (NFIs) were calculated. Mixed-effects models with random effects for intercept were used to examine the association of Neuropsychiatric State Score and NFI with the different assessment conditions. Results In acute challenge conditions, there was an estimated increase of 15.9 points in the Neuropsychiatric State Score in stimulation ON conditions (95% CI 11.4 to 20.6, p<0.001) and 7.6 points in medication ON conditions (95% CI 3.3 to 11.9, p<0.001). Neuropsychiatric fluctuations induced by levodopa, quantified with NFI, decreased by 35.54% (95% CI 49.3 to 21.8, p<0.001) 1 year after STN-DBS. Conclusions Bilateral STN-DBS at therapeutic parameters has acute psychotropic effects similar to levodopa and can modulate and decrease levodopa-induced neuropsychiatric fluctuations.
Collapse
Affiliation(s)
- Andreia D Magalhães
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Deborah Amstutz
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Katrin Petermann
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Mário Sousa
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Marie E Maradan-Gachet
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | | | - Julia Waskönig
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | | | | | - Gerd Tinkhauser
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Inselspital University Hospital Bern, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, Inselspital University Hospital Bern, Bern, Switzerland
| | - Carmen Rodriguez-Blazquez
- National Epidemiology Center, Carlos III Health Institute, Madrid, Spain
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, Madrid, Spain
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, Madrid, Spain
| | - Paul Krack
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| |
Collapse
|
8
|
Benis D, Voruz P, Chiuve SC, Garibotto V, Assal F, Krack P, Péron J, Fleury V. Electroencephalographic Abnormalities in a Patient Suffering from Long-Term Neuropsychological Complications following SARS-CoV-2 Infection. Case Rep Neurol 2024; 16:6-17. [PMID: 38179211 PMCID: PMC10764086 DOI: 10.1159/000535241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/07/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Emotional apathy has recently been identified as a common symptom of long COVID. While recent meta-analyses have demonstrated generalized EEG slowing with the emergence of delta rhythms in patients hospitalized for severe SARS-CoV-2 infection, no EEG study or dopamine transporter scintigraphy (DaTSCAN) has been performed in patients with long COVID presenting with apathy. The objective of this case report was to explore the pathophysiology of neuropsychological symptoms in long COVID. Case Presentation A 47-year-old patient who developed a long COVID with prominent apathy following an initially clinically mild SARS-CoV-2 infection underwent neuropsychological assessment, cerebral MRI, DaTSCAN, and resting-state high-density EEG 7 months after SARS-CoV-2 infection. The EEG data were compared to those of 21 healthy participants. The patient presented with apathy, cognitive difficulties with dysexecutive syndrome, moderate attentional and verbal episodic memory disturbances, and resolution of premorbid mild gaming disorder, mild mood disturbances, and sleep disturbances. His MRI and DaTSCAN were unremarkable. EEG revealed a complex pattern of oscillatory abnormalities compared to the control group, with a strong increase in whole-scalp delta and beta band activity, as well as a decrease in alpha band activity. Overall, these effects were more prominent in the frontal-central-temporal region. Conclusion These results suggest widespread changes in EEG oscillatory patterns in a patient with long COVID characterized by neuropsychological complications with prominent apathy. Despite the inherent limitations of a case report, these results suggest dysfunction in the cortical networks involved in motivation and emotion.
Collapse
Affiliation(s)
- Damien Benis
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences, Clinical and Experimental Neuropsychology Laboratory, University of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences and Swiss Centre for Affective Sciences, Neuroscience of Emotion and Affective Dynamics (NEAD) Laboratory, University of Geneva, Geneva, Switzerland
| | - Philippe Voruz
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences, Clinical and Experimental Neuropsychology Laboratory, University of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences and Swiss Centre for Affective Sciences, Neuroscience of Emotion and Affective Dynamics (NEAD) Laboratory, University of Geneva, Geneva, Switzerland
| | | | - Valentina Garibotto
- Nuclear Medicine and Molecular Division, University Hospitals of Geneva, Geneva, Switzerland
| | - Frédéric Assal
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Paul Krack
- Neurology Department, University Bern, Bern, Switzerland
| | - Julie Péron
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences, Clinical and Experimental Neuropsychology Laboratory, University of Geneva, Geneva, Switzerland
| | - Vanessa Fleury
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
9
|
Cuartero MC, Grabli D, Flamand-Roze E, Karachi C, Rouaud T, Derkinderen P, Damier P, Raoul S, Krack P, Moro E, Fraix V, Chabardès S, Burbaud P, Guehl D, Cuny E, Pinto S, Vidailhet M. Lessons from multitarget neurostimulation in isolated dystonia: Less is more? Brain Stimul 2024; 17:104-106. [PMID: 38182095 DOI: 10.1016/j.brs.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/22/2023] [Indexed: 01/07/2024] Open
Affiliation(s)
- Marie-Charlotte Cuartero
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière (ICM), Centre d'Investigation Clinique (CIC) 1422, Paris, France; Aix-Marseille Univ, CNRS, LPL, Aix-en-Provence, France.
| | - David Grabli
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière (ICM), Centre d'Investigation Clinique (CIC) 1422, Paris, France
| | - Emmanuel Flamand-Roze
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière (ICM), Centre d'Investigation Clinique (CIC) 1422, Paris, France
| | - Carine Karachi
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière (ICM), Centre d'Investigation Clinique (CIC) 1422, Paris, France
| | - Tiphaine Rouaud
- Department of Neurology, Nantes Université, CHU Nantes, INSERM, Nantes, France
| | - Pascal Derkinderen
- Department of Neurology, Nantes Université, CHU Nantes, INSERM, Nantes, France
| | - Philippe Damier
- Department of Neurology, Nantes Université, CHU Nantes, INSERM, Nantes, France
| | - Sylvie Raoul
- Department of Neurosurgery, Nantes Université, CHU Nantes, INSERM, Nantes, France
| | - Paul Krack
- Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Elena Moro
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Neurology Department, Grenoble, France
| | - Valérie Fraix
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Neurology Department, Grenoble, France
| | - Stéphan Chabardès
- Univ. Grenoble Alpes, CEA, LETI, Clinatec, Department Neurosurgery, Grenoble, France
| | - Pierre Burbaud
- Department of Clinical Neurosciences, CHU Bordeaux & IMN CNRS UMR 5293, CNRS, University of Bordeaux, Bordeaux, France
| | - Dominique Guehl
- Department of Clinical Neurosciences, CHU Bordeaux & IMN CNRS UMR 5293, CNRS, University of Bordeaux, Bordeaux, France
| | - Emmanuel Cuny
- Department of Neurosurgery, CHU Bordeaux & IMN CNRS UMR 5293, CNRS, University of Bordeaux, Bordeaux, France
| | - Serge Pinto
- Aix-Marseille Univ, CNRS, LPL, Aix-en-Provence, France
| | - Marie Vidailhet
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière (ICM), Centre d'Investigation Clinique (CIC) 1422, Paris, France.
| |
Collapse
|
10
|
Béreau M, Castrioto A, Servant M, Lhommée E, Desmarets M, Bichon A, Pélissier P, Schmitt E, Klinger H, Longato N, Phillipps C, Wirth T, Fraix V, Benatru I, Durif F, Azulay JP, Moro E, Broussolle E, Thobois S, Tranchant C, Krack P, Anheim M. Imbalanced motivated behaviors according to motor sign asymmetry in drug-naïve Parkinson's disease. Sci Rep 2023; 13:21234. [PMID: 38040775 PMCID: PMC10692157 DOI: 10.1038/s41598-023-48188-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023] Open
Abstract
Few studies have considered the influence of motor sign asymmetry on motivated behaviors in de novo drug-naïve Parkinson's disease (PD). We tested whether motor sign asymmetry could be associated with different motivated behavior patterns in de novo drug-naïve PD. We performed a cross-sectional study in 128 de novo drug-naïve PD patients and used the Ardouin Scale of Behavior in Parkinson's disease (ASBPD) to assess a set of motivated behaviors. We assessed motor asymmetry based on (i) side of motor onset and (ii) MDS-UPDRS motor score, then we compared right hemibody Parkinson's disease to left hemibody Parkinson's disease. According to the MDS-UPDRS motor score, patients with de novo right hemibody PD had significantly lower frequency of approach behaviors (p = 0.031), including nocturnal hyperactivity (p = 0.040), eating behavior (p = 0.040), creativity (p = 0.040), and excess of motivation (p = 0.017) than patients with de novo left hemibody PD. Patients with de novo left hemibody PD did not significantly differ from those with de novo right hemibody PD regarding avoidance behaviors including apathy, anxiety and depression. Our findings suggest that motor sign asymmetry may be associated with an imbalance between motivated behaviors in de novo drug-naïve Parkinson's disease.
Collapse
Affiliation(s)
- Matthieu Béreau
- Neurology Department, University Hospital of Besançon, CHRU de Besançon, 3 Bd Alexandre Fleming, 25030, Besançon Cedex, France.
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche-Comté, Besançon, France.
| | - Anna Castrioto
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Mathieu Servant
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche-Comté, Besançon, France
| | - Eugénie Lhommée
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Maxime Desmarets
- Unité de Méthodologie, CIC INSERM 1431, CHU de Besançon, Besançon, France
| | - Amélie Bichon
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Pierre Pélissier
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Emmanuelle Schmitt
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Hélène Klinger
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Nadine Longato
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Clélie Phillipps
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Thomas Wirth
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104, Université de Strasbourg, Illkirch, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Valérie Fraix
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Isabelle Benatru
- Neurology Department, University Hospital of Poitiers, Poitiers, France
- INSERM, CHU de Poitiers, Centre d'Investigation Clinique CIC1402, University of Poitiers, Poitiers, France
| | - Franck Durif
- EA7280 NPsy-Sydo, Université Clermont Auvergne, Clermont-Ferrand, France
- Neurology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Jean-Philippe Azulay
- Movement Disorders Unit, Neurology Department, University Hospital of Marseille, Marseille, France
| | - Elena Moro
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Emmanuel Broussolle
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Stéphane Thobois
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Paul Krack
- Department of Neurology, Movement Disorders Center, University Hospital of Bern, Bern, Switzerland
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104, Université de Strasbourg, Illkirch, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| |
Collapse
|
11
|
Depienne C, Ciura S, Trouillard O, Bouteiller D, Leitão E, Nava C, Keren B, Marie Y, Guegan J, Forlani S, Brice A, Anheim M, Agid Y, Krack P, Damier P, Viallet F, Houeto JL, Durif F, Vidailhet M, Worbe Y, Roze E, Kabashi E, Hartmann A. Correction: Association of Rare Genetic Variants in Opioid Receptors with Tourette Syndrome. Tremor Other Hyperkinet Mov (N Y) 2023; 13:22. [PMID: 37457636 PMCID: PMC10348064 DOI: 10.5334/tohm.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
[This corrects the article DOI: 10.5334/tohm.464.].
Collapse
Affiliation(s)
- Christel Depienne
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
- Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, DE
| | - Sorana Ciura
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Oriane Trouillard
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Delphine Bouteiller
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Elsa Leitão
- Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, DE
| | - Caroline Nava
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
- Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Génétique, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Boris Keren
- Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Génétique, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Yannick Marie
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Justine Guegan
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Sylvie Forlani
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Alexis Brice
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Mathieu Anheim
- Service de neurologie, CHU de Strasbourg, Hôpital de Hautepierre, Avenue Molière, 67200 Strasbourg Strasbourg, FR
| | - Yves Agid
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Paul Krack
- Service de Neurologie, CHU de Grenoble, Avenue Maquis du Grésivaudan, 38700 La Tronche, FR
- Center for Movement Disorders, Inselspital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland
| | - Philippe Damier
- Service de Neurologie, CHU de Nantes, 5 Allée de l’Île Gloriette, 44093 Nantes, FR
| | - François Viallet
- Service de Neurologie, CRHU d’Aix-en-Provence, Avenue des Tamaris, 13100 Aix-en-Provence, FR
| | - Jean-Luc Houeto
- Service de Neurologie, CHU de Poitiers, 2 Rue de la Milétrie, 86021 Poitiers, FR
| | - Franck Durif
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
- Service de Neurologie, CHU de Clermont-Ferrand, CHU de Clermont-Ferrand, Hôpital Gabriel Montpied, 58 rue Montalembert, 63003 Clermont-Ferrand, FR
| | - Marie Vidailhet
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
- Assistance Publique Hôpitaux de Paris (APHP), Hôpital Pitié-Salpêtrière, Département de Neurologie, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Yulia Worbe
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
- Assistance Publique Hôpitaux de Paris (APHP), Hôpital Pitié-Salpêtrière, Département de Neurologie, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
- AP-HP, Centre de Référence National Maladie Rare ‘Syndrome Gilles de la Tourette’, Hôpital Pitié- Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Emmanuel Roze
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
- AP-HP, Centre de Référence National Maladie Rare ‘Syndrome Gilles de la Tourette’, Hôpital Pitié- Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Edor Kabashi
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| | - Andreas Hartmann
- INSERM, U 1127, CNRS UMR 7225, Faculté de Médecine de Sorbonne Université, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
- Assistance Publique Hôpitaux de Paris (APHP), Hôpital Pitié-Salpêtrière, Département de Neurologie, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
- AP-HP, Centre de Référence National Maladie Rare ‘Syndrome Gilles de la Tourette’, Hôpital Pitié- Salpêtrière, 47-83 Boulevard de l’Hôpital, 75013 Paris, FR
| |
Collapse
|
12
|
Segura-Amil A, Nowacki A, Debove I, Petermann K, Tinkhauser G, Krack P, Pollo C, Nguyen TAK. Programming of subthalamic nucleus deep brain stimulation with hyperdirect pathway and corticospinal tract-guided parameter suggestions. Hum Brain Mapp 2023. [PMID: 37318767 PMCID: PMC10365233 DOI: 10.1002/hbm.26390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/16/2023] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for advanced Parkinson's disease. Stimulation of the hyperdirect pathway (HDP) may mediate the beneficial effects, whereas stimulation of the corticospinal tract (CST) mediates capsular side effects. The study's objective was to suggest stimulation parameters based on the activation of the HDP and CST. This retrospective study included 20 Parkinson's disease patients with bilateral STN DBS. Patient-specific whole-brain probabilistic tractography was performed to extract the HDP and CST. Stimulation parameters from monopolar reviews were used to estimate volumes of tissue activated and to determine the streamlines of the pathways inside these volumes. The activated streamlines were related to the clinical observations. Two models were computed, one for the HDP to estimate effect thresholds and one for the CST to estimate capsular side effect thresholds. In a leave-one-subject-out cross-validation, the models were used to suggest stimulation parameters. The models indicated an activation of 50% of the HDP at effect threshold, and 4% of the CST at capsular side effect threshold. The suggestions for best and worst levels were significantly better than random suggestions. Finally, we compared the suggested stimulation thresholds with those from the monopolar reviews. The median suggestion errors for the effect threshold and side effect threshold were 1 and 1.5 mA, respectively. Our stimulation models of the HDP and CST suggested STN DBS settings. Prospective clinical studies are warranted to optimize tract-guided DBS programming. Together with other modalities, these may allow for assisted STN DBS programming.
Collapse
Affiliation(s)
- Alba Segura-Amil
- Department of Neurosurgery, University Hospital Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University Bern, Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, University Hospital Bern, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, University Hospital Bern, Bern, Switzerland
| | - Katrin Petermann
- Department of Neurology, University Hospital Bern, Bern, Switzerland
| | - Gerd Tinkhauser
- Department of Neurology, University Hospital Bern, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, University Hospital Bern, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, University Hospital Bern, Bern, Switzerland
| | - T A Khoa Nguyen
- Department of Neurosurgery, University Hospital Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University Bern, Bern, Switzerland
| |
Collapse
|
13
|
Averna A, Debove I, Nowacki A, Peterman K, Duchet B, Sousa M, Bernasconi E, Alva L, Lachenmayer ML, Schuepbach M, Pollo C, Krack P, Nguyen TAK, Tinkhauser G. Spectral Topography of the Subthalamic Nucleus to Inform Next-Generation Deep Brain Stimulation. Mov Disord 2023; 38:818-830. [PMID: 36987385 PMCID: PMC7615852 DOI: 10.1002/mds.29381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/13/2023] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The landscape of neurophysiological symptoms and behavioral biomarkers in basal ganglia signals for movement disorders is expanding. The clinical translation of sensing-based deep brain stimulation (DBS) also requires a thorough understanding of the anatomical organization of spectral biomarkers within the subthalamic nucleus (STN). OBJECTIVES The aims were to systematically investigate the spectral topography, including a wide range of sub-bands in STN local field potentials (LFP) of Parkinson's disease (PD) patients, and to evaluate its predictive performance for clinical response to DBS. METHODS STN-LFPs were recorded from 70 PD patients (130 hemispheres) awake and at rest using multicontact DBS electrodes. A comprehensive spatial characterization, including hot spot localization and focality estimation, was performed for multiple sub-bands (delta, theta, alpha, low-beta, high-beta, low-gamma, high-gamma, and fast-gamma (FG) as well as low- and fast high-frequency oscillations [HFO]) and compared to the clinical hot spot for rigidity response to DBS. A spectral biomarker map was established and used to predict the clinical response to DBS. RESULTS The STN shows a heterogeneous topographic distribution of different spectral biomarkers, with the strongest segregation in the inferior-superior axis. Relative to the superiorly localized beta hot spot, HFOs (FG, slow HFO) were localized up to 2 mm more inferiorly. Beta oscillations are spatially more spread compared to other sub-bands. Both the spatial proximity of contacts to the beta hot spot and the distance to higher-frequency hot spots were predictive for the best rigidity response to DBS. CONCLUSIONS The spatial segregation and properties of spectral biomarkers within the DBS target structure can additionally be informative for the implementation of next-generation sensing-based DBS. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Alberto Averna
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Katrin Peterman
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Benoit Duchet
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom
| | - Mário Sousa
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Elena Bernasconi
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Laura Alva
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Martin L. Lachenmayer
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | | | - Claudio Pollo
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Thuy-Anh K. Nguyen
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Gerd Tinkhauser
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| |
Collapse
|
14
|
Hariz M, Bronstein JM, Cosgrove GR, de Bie RMA, DeLong MR, Gross RE, Krack P, Krauss JK, Lang AE, Lees AJ, Lozano AM, Obeso JA, Schuurman PR, Vitek JL. Concerns About the European Academy's Recommendations and Guidelines Regarding Pallidotomy for Parkinson's Disease. Mov Disord 2023; 38:509-511. [PMID: 36047463 DOI: 10.1002/mds.29210] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Marwan Hariz
- Department of Clinical Neuroscience, Umeå University, Umeå, Sweden
- UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Jeff M Bronstein
- Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - G Rees Cosgrove
- Neurosurgery Department at The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rob M A de Bie
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Mahlon R DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Robert E Gross
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Joachim K Krauss
- Department of Neurosurgery, Medical School Hannover, Hannover, Germany
| | - Anthony E Lang
- The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital & University of Toronto, Toronto, Ontario, Canada
| | - Andrew J Lees
- UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - José A Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Fundación Hospitales de Madrid, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- University CEU-San Pablo, Madrid, Spain
| | | | - Jerold L Vitek
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
15
|
Debove I, Petermann K, Nowacki A, Nguyen TK, Tinkhauser G, Michelis JP, Muellner J, Amstutz D, Bargiotas P, Fichtner J, Schlaeppi JA, Krack P, Schuepbach M, Pollo C, Lachenmayer ML. Deep Brain Stimulation: When to Test Directional? Mov Disord Clin Pract 2023; 10:434-439. [PMID: 36949800 PMCID: PMC10026308 DOI: 10.1002/mdc3.13667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/09/2022] [Accepted: 01/08/2023] [Indexed: 01/26/2023] Open
Abstract
Background Directional deep brain stimulation (DBS) allows for steering of the stimulation field, but extensive and time-consuming testing of all segmented contacts is necessary to identify the possible benefit of steering. It is therefore important to determine under which circumstances directional current steering is advantageous. Methods Fifty two Parkinson's disease patients implanted in the STN with a directional DBS system underwent a standardized monopolar programming session 5 to 9 months after implantation. Individual contacts were tested for a potential advantage of directional stimulation. Results were used to build a prediction model for the selection of ring levels that would benefit from directional stimulation. Results On average, there was no significant difference in therapeutic window between ring-level contact and best directional contact. However, according to our standardized protocol, 35% of the contacts and 66% of patients had a larger therapeutic window under directional stimulation compared to ring-mode. The segmented contacts warranting directional current steering could be predicted with a sensitivity of 79% and a specificity of 57%. Conclusion To reduce time required for DBS programming, we recommend additional directional contact testing initially only on ring-level contacts with a therapeutic window of less than 2.0 mA.
Collapse
Affiliation(s)
- Ines Debove
- Department of Neurology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Katrin Petermann
- Department of Neurology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Thuy‐Anh Khoa Nguyen
- Department of Neurosurgery, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
- ARTORG Center for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
| | - Gerd Tinkhauser
- Department of Neurology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Joan Philipp Michelis
- Department of Neurology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Julia Muellner
- Department of Neurology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Deborah Amstutz
- Department of Neurology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Panagiotis Bargiotas
- Department of Neurology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
- Department of Neurology, Medical SchoolUniversity of CyprusNicosiaCyprus
| | - Jens Fichtner
- Department of Neurosurgery, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
- Cantonal Medical Service, Department of Health of the Canton of BernBernSwitzerland
| | - Janine Ai Schlaeppi
- Department of Neurosurgery, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Paul Krack
- Department of Neurology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Michael Schuepbach
- Department of Neurology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | - Claudio Pollo
- Department of Neurosurgery, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
| | | |
Collapse
|
16
|
Mavragani A, Bruhin LC, Schütz N, Naef AC, Hegi H, Reuse P, Schindler KA, Krack P, Wiest R, Chan A, Nef T, Gerber SM. Development of an Open-source and Lightweight Sensor Recording Software System for Conducting Biomedical Research: Technical Report. JMIR Form Res 2023; 7:e43092. [PMID: 36800219 PMCID: PMC9985000 DOI: 10.2196/43092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/28/2022] [Accepted: 01/03/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Digital sensing devices have become an increasingly important component of modern biomedical research, as they help provide objective insights into individuals' everyday behavior in terms of changes in motor and nonmotor symptoms. However, there are significant barriers to the adoption of sensor-enhanced biomedical solutions in terms of both technical expertise and associated costs. The currently available solutions neither allow easy integration of custom sensing devices nor offer a practicable methodology in cases of limited resources. This has become particularly relevant, given the need for real-time sensor data that could help lower health care costs by reducing the frequency of clinical assessments performed by specialists and improve access to health assessments (eg, for people living in remote areas or older adults living at home). OBJECTIVE The objective of this paper is to detail the end-to-end development of a novel sensor recording software system that supports the integration of heterogeneous sensor technologies, runs as an on-demand service on consumer-grade hardware to build sensor systems, and can be easily used to reliably record longitudinal sensor measurements in research settings. METHODS The proposed software system is based on a server-client architecture, consisting of multiple self-contained microservices that communicated with each other (eg, the web server transfers data to a database instance) and were implemented as Docker containers. The design of the software is based on state-of-the-art open-source technologies (eg, Node.js or MongoDB), which fulfill nonfunctional requirements and reduce associated costs. A series of programs to facilitate the use of the software were documented. To demonstrate performance, the software was tested in 3 studies (2 gait studies and 1 behavioral study assessing activities of daily living) that ran between 2 and 225 days, with a total of 114 participants. We used descriptive statistics to evaluate longitudinal measurements for reliability, error rates, throughput rates, latency, and usability (with the System Usability Scale [SUS] and the Post-Study System Usability Questionnaire [PSSUQ]). RESULTS Three qualitative features (event annotation program, sample delay analysis program, and monitoring dashboard) were elaborated and realized as integrated programs. Our quantitative findings demonstrate that the system operates reliably on consumer-grade hardware, even across multiple months (>420 days), providing high throughput (2000 requests per second) with a low latency and error rate (<0.002%). In addition, the results of the usability tests indicate that the system is effective, efficient, and satisfactory to use (mean usability ratings for the SUS and PSSUQ were 89.5 and 1.62, respectively). CONCLUSIONS Overall, this sensor recording software could be leveraged to test sensor devices, as well as to develop and validate algorithms that are able to extract digital measures (eg, gait parameters or actigraphy). The proposed software could help significantly reduce barriers related to sensor-enhanced biomedical research and allow researchers to focus on the research questions at hand rather than on developing recording technologies.
Collapse
Affiliation(s)
| | - Lena C Bruhin
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Narayan Schütz
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,DomoHealth SA, Lausanne, Switzerland
| | - Aileen C Naef
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Heinz Hegi
- Department of Sport Science, University of Bern, Bern, Switzerland
| | - Pascal Reuse
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Kaspar A Schindler
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrew Chan
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tobias Nef
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stephan M Gerber
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| |
Collapse
|
17
|
van Wegen M, Herder JL, Adelsberger R, Pastore-Wapp M, van Wegen EEH, Bohlhalter S, Nef T, Krack P, Vanbellingen T. An Overview of Wearable Haptic Technologies and Their Performance in Virtual Object Exploration. Sensors (Basel) 2023; 23:1563. [PMID: 36772603 PMCID: PMC9919508 DOI: 10.3390/s23031563] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
We often interact with our environment through manual handling of objects and exploration of their properties. Object properties (OP), such as texture, stiffness, size, shape, temperature, weight, and orientation provide necessary information to successfully perform interactions. The human haptic perception system plays a key role in this. As virtual reality (VR) has been a growing field of interest with many applications, adding haptic feedback to virtual experiences is another step towards more realistic virtual interactions. However, integrating haptics in a realistic manner, requires complex technological solutions and actual user-testing in virtual environments (VEs) for verification. This review provides a comprehensive overview of recent wearable haptic devices (HDs) categorized by the OP exploration for which they have been verified in a VE. We found 13 studies which specifically addressed user-testing of wearable HDs in healthy subjects. We map and discuss the different technological solutions for different OP exploration which are useful for the design of future haptic object interactions in VR, and provide future recommendations.
Collapse
Affiliation(s)
- Myla van Wegen
- Department of Precision and Microsystems Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Just L. Herder
- Department of Precision and Microsystems Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | | | - Manuela Pastore-Wapp
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland
- Neurocenter, Luzerner Kantonsspital, 6000 Luzern, Switzerland
| | - Erwin E. H. van Wegen
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, VUmc, 1117 HV Amsterdam, The Netherlands
| | | | - Tobias Nef
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland
| | - Paul Krack
- Department of Neurology, Center for Parkinson’s Disease and Movement Disorders, Inselspital, Bern University Hospital, University of Bern, 3008 Bern, Switzerland
| | - Tim Vanbellingen
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland
- Neurocenter, Luzerner Kantonsspital, 6000 Luzern, Switzerland
| |
Collapse
|
18
|
Pinto S, Nebel A, Rau J, Espesser R, Maillochon P, Niebuhr O, Krack P, Witjas T, Ghio A, Cuartero MC, Timmermann L, Schnitzler A, Hesekamp H, Meier N, Müllner J, Hälbig TD, Möller B, Paschen S, Paschen L, Volkmann J, Barbe MT, Fink GR, Becker J, Reker P, Kühn AA, Schneider GH, Fraix V, Seigneuret E, Kistner A, Rascol O, Brefel-Courbon C, Ory-Magne F, Hartmann CJ, Wojtecki L, Fradet A, Maltête D, Damier P, Le Dily S, Sixel-Döring F, Benecke P, Weiss D, Wächter T, Pinsker MO, Régis J, Thobois S, Polo G, Houeto JL, Hartmann A, Knudsen K, Vidailhet M, Schüpbach M, Deuschl G. Results of a Randomized Clinical Trial of Speech After Early Neurostimulation in Parkinson's Disease. Mov Disord 2023; 38:212-222. [PMID: 36461899 DOI: 10.1002/mds.29282] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND The EARLYSTIM trial demonstrated for Parkinson's disease patients with early motor complications that deep brain stimulation of the subthalamic nucleus (STN-DBS) and best medical treatment (BMT) was superior to BMT alone. OBJECTIVE This prospective, ancillary study on EARLYSTIM compared changes in blinded speech intelligibility assessment between STN-DBS and BMT over 2 years, and secondary outcomes included non-speech oral movements (maximum phonation time [MPT], oral diadochokinesis), physician- and patient-reported assessments. METHODS STN-DBS (n = 102) and BMT (n = 99) groups underwent assessments on/off medication at baseline and 24 months (in four conditions: on/off medication, ON/OFF stimulation-for STN-DBS). Words and sentences were randomly presented to blinded listeners, and speech intelligibility rate was measured. Statistical analyses compared changes between the STN-DBS and BMT groups from baseline to 24 months. RESULTS Over the 2-year period, changes in speech intelligibility and MPT, as well as patient-reported outcomes, were not different between groups, either off or on medication or OFF or ON stimulation, but most outcomes showed a nonsignificant trend toward worsening in both groups. Change in oral diadochokinesis was significantly different between STN-DBS and BMT groups, on medication and OFF STN-DBS, with patients in the STN-DBS group performing slightly worse than patients under BMT only. A signal for clinical worsening with STN-DBS was found for the individual speech item of the Unified Parkinson's Disease Rating Scale, Part III. CONCLUSION At this early stage of the patients' disease, STN-DBS did not result in a consistent deterioration in blinded speech intelligibility assessment and patient-reported communication, as observed in studies of advanced Parkinson's Disease. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Serge Pinto
- Aix-Marseille Univ, CNRS, LPL, Aix-en-Provence, France
| | - Adelheid Nebel
- Department of Neurology, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Jörn Rau
- Coordinating Centre for Clinical Trials of the Philipps-University of Marburg, Marburg, Germany
| | | | | | - Oliver Niebuhr
- Department of Scandinavian Studies, Frisian, and General Linguistics, Kiel University, Kiel, Germany
| | - Paul Krack
- Department of Neurology or Neurosurgery, Grenoble University Hospital, Grenoble Alpes University, Grenoble Institut des Neurosciences, Grenoble, France
| | - Tatiana Witjas
- Aix Marseille Univ, APHM, La Timone, Neurology Department or Department of Functional and Stereotactic Neurosurgery and Radiosurgery, Marseille, France
| | - Alain Ghio
- Aix-Marseille Univ, CNRS, LPL, Aix-en-Provence, France
| | | | - Lars Timmermann
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Alfons Schnitzler
- Department of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Helke Hesekamp
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière, and Centre d'Investigation Clinique (CIC), Paris, France
| | - Niklaus Meier
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière, and Centre d'Investigation Clinique (CIC), Paris, France
| | - Julia Müllner
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière, and Centre d'Investigation Clinique (CIC), Paris, France
| | - Thomas D Hälbig
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière, and Centre d'Investigation Clinique (CIC), Paris, France
| | - Bettina Möller
- Department of Neurology, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Steffen Paschen
- Department of Neurology, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Laura Paschen
- Department of Neurology, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Jens Volkmann
- Department of Neurology, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Michael T Barbe
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Gereon R Fink
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Johannes Becker
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Paul Reker
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité Hospital, Berlin University, Berlin, Germany
| | | | - Valérie Fraix
- Department of Neurology or Neurosurgery, Grenoble University Hospital, Grenoble Alpes University, Grenoble Institut des Neurosciences, Grenoble, France
| | - Eric Seigneuret
- Department of Neurology or Neurosurgery, Grenoble University Hospital, Grenoble Alpes University, Grenoble Institut des Neurosciences, Grenoble, France
| | - Andrea Kistner
- Department of Neurology or Neurosurgery, Grenoble University Hospital, Grenoble Alpes University, Grenoble Institut des Neurosciences, Grenoble, France
| | - Olivier Rascol
- Department of Neurology and Centre Expert Parkinson, and INSERM U1214, Toulouse University Hospital, Toulouse NeuroImaging Centre, Toulouse, France
| | - Christine Brefel-Courbon
- Department of Neurology and Centre Expert Parkinson, and INSERM U1214, Toulouse University Hospital, Toulouse NeuroImaging Centre, Toulouse, France
| | - Fabienne Ory-Magne
- Department of Neurology and Centre Expert Parkinson, and INSERM U1214, Toulouse University Hospital, Toulouse NeuroImaging Centre, Toulouse, France
| | - Christian J Hartmann
- Department of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Lars Wojtecki
- Department of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Anne Fradet
- Department of Neurology, CIC-INSERM 1402, CHU de Poitiers, Université de Poitiers, Poitiers, France
| | - David Maltête
- Department of Neurology, Rouen University Hospital, INSERM U1073, Rouen Faculty of Medicine, Rouen, France
| | - Philippe Damier
- CHU Nantes, INSERM, CIC1413, Hôpital Laënnec, Nantes, France
| | | | | | - Petra Benecke
- Department of Neurology, Paracelsus-Elena-Klinik, Kassel, Germany
| | - Daniel Weiss
- Department for Neurodegenerative Diseases, Centre for Neurology, and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Tobias Wächter
- Department for Neurodegenerative Diseases, Centre for Neurology, and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Marcus O Pinsker
- Department of Neurosurgery, University Hospital, Freiburg, Germany
| | - Jean Régis
- Aix Marseille Univ, APHM, La Timone, Neurology Department or Department of Functional and Stereotactic Neurosurgery and Radiosurgery, Marseille, France
| | - Stéphane Thobois
- Hôpital Neurologique Pierre Wertheimer, Centre Expert Parkinson, Hospices Civils de Lyon, Université Claude Bernard Lyon 1 Lyon, France, and Centre de Neurosciences Cognitives, Bron, France
| | - Gustavo Polo
- Hôpital Neurologique Pierre Wertheimer, Centre Expert Parkinson, Hospices Civils de Lyon, Université Claude Bernard Lyon 1 Lyon, France, and Centre de Neurosciences Cognitives, Bron, France
| | - Jean-Luc Houeto
- Department of Neurology, CIC-INSERM 1402, CHU de Poitiers, Université de Poitiers, Poitiers, France
| | - Andreas Hartmann
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière, and Centre d'Investigation Clinique (CIC), Paris, France
| | - Karina Knudsen
- Department of Neurology, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Marie Vidailhet
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière, and Centre d'Investigation Clinique (CIC), Paris, France
| | - Michael Schüpbach
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), INSERM, Institut du Cerveau et de la Moelle Epinière, and Centre d'Investigation Clinique (CIC), Paris, France
| | - Günther Deuschl
- Department of Neurology, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | | |
Collapse
|
19
|
Pérennou D, Dai S, Gastaldi R, Fraix V, Leroux N, Clarac E, Davoine P, Piscicelli C, Krack P. Retropulsion with tilted postural vertical causing backward falls in an individual with Parkinson's disease: Improvement by specific rehabilitation. Ann Phys Rehabil Med 2023; 66:101728. [PMID: 36645930 DOI: 10.1016/j.rehab.2022.101728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/02/2022] [Accepted: 11/19/2022] [Indexed: 01/15/2023]
Affiliation(s)
- Dominic Pérennou
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition (LPNC), Grenoble-Alpes University Hospital (South Site), Dept of NeuroRehabilitation, Cs 10217 - 38043 Grenoble cedex 9, France.
| | - Shenhao Dai
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition (LPNC), Grenoble-Alpes University Hospital (South Site), Dept of NeuroRehabilitation, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Romain Gastaldi
- Department of Rheumatology, Grenoble-Alpes University Hospital (South Site), Cs 10217 - 38043 Grenoble cedex 9, France
| | - Valérie Fraix
- Univ. Grenoble-Alpes, INSERM U1216 Grenoble Institute Neurosciences (GIN), Dept of Neurology Grenoble-Alpes University Hospital (North Site), 38000 Grenoble, France
| | - Nicolas Leroux
- Univ. Grenoble-Alpes, INSERM U1216 Grenoble Institute Neurosciences (GIN), Dept of Neurology Grenoble-Alpes University Hospital (North Site), 38000 Grenoble, France
| | - Emmanuelle Clarac
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition (LPNC), Grenoble-Alpes University Hospital (South Site), Dept of NeuroRehabilitation, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Patrice Davoine
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition (LPNC), Grenoble-Alpes University Hospital (South Site), Dept of NeuroRehabilitation, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Céline Piscicelli
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition (LPNC), Grenoble-Alpes University Hospital (South Site), Dept of NeuroRehabilitation, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Paul Krack
- Univ. Grenoble-Alpes, INSERM U1216 Grenoble Institute Neurosciences (GIN), Dept of Neurology Grenoble-Alpes University Hospital (North Site), 38000 Grenoble, France; Department of Neurology, Center for Parkinson's disease and Movement Disorders, Inselspital, Bern University Hospital, University of Bern, Switzerland
| |
Collapse
|
20
|
Hariz M, Lang AE, Bronstein JM, Cosgrove GR, de Bie RMA, DeLong MR, Gross RE, Krack P, Krauss JK, Lees AJ, Lozano AM, Obeso JA, Schuurman PR, Vitek JL. European Academy of Neurology/Movement Disorder Society European Section's guidelines on pallidotomy for Parkinson's disease: let's remain accurate. Eur J Neurol 2022. [PMID: 36583626 DOI: 10.1111/ene.15667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Marwan Hariz
- Department of Clinical Neuroscience, Umeå University, Umeå, Sweden.,UCL Queen Square Institute of Neurology, London, UK
| | - Anthony E Lang
- Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Jeff M Bronstein
- Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - G Rees Cosgrove
- Neurosurgery Department, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rob M A de Bie
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Mahlon R DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Robert E Gross
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Joachim K Krauss
- Department of Neurosurgery, Medical School Hannover, Hannover, Germany
| | | | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - José A Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Fundación Hospitales de Madrid, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,University CEU-San Pablo, Madrid, Spain
| | | | - Jerrold L Vitek
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
21
|
Svihlik J, Novotny M, Tykalova T, Polakova K, Brozova H, Kryze P, Sousa M, Krack P, Tripoliti E, Ruzicka E, Jech R, Rusz J. Long-Term Averaged Spectrum Descriptors of Dysarthria in Patients With Parkinson's Disease Treated With Subthalamic Nucleus Deep Brain Stimulation. J Speech Lang Hear Res 2022; 65:4690-4699. [PMID: 36472939 DOI: 10.1044/2022_jslhr-22-00308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE This study aimed to evaluate whether long-term averaged spectrum (LTAS) descriptors for reading and monologue are suitable to detect worsening of dysarthria in patients with Parkinson's disease (PD) treated with subthalamic nucleus deep brain stimulation (STN-DBS) with potential effect of ON and OFF stimulation conditions and types of connected speech. METHOD Four spectral moments based on LTAS were computed for monologue and reading passage collected from 23 individuals with PD treated with bilateral STN-DBS and 23 age- and gender-matched healthy controls. Speech performance of patients with PD was compared in ON and OFF STN-DBS conditions. RESULTS All LTAS spectral moments including mean, standard deviation, skewness, and kurtosis across both monologue and reading passage were able to significantly distinguish between patients with PD in both stimulation conditions and control speakers. The spectral mean was the only LTAS measure sensitive to capture better speech performance in STN-DBS ON, as compared to the STN-DBS OFF stimulation condition (p < .05). Standardized reading passage was more sensitive compared to monologue in detecting dysarthria severity via LTAS descriptors with an area under the curve of up to 0.92 obtained between PD and control groups. CONCLUSIONS Our findings confirmed that LTAS is a suitable approach to objectively describe changes in speech impairment severity due to STN-DBS therapy in patients with PD. We envisage these results as an important step toward a continuum development of technological solutions for the automated assessment of stimulation-induced dysarthria. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21644798.
Collapse
Affiliation(s)
- Jan Svihlik
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
- Department of Computing and Control Engineering, Faculty of Chemical Engineering, University of Chemistry and Technology, Prague, Czech Republic
| | - Michal Novotny
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
| | - Tereza Tykalova
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
| | - Kamila Polakova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
| | - Hana Brozova
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
| | - Petr Kryze
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
| | - Mario Sousa
- Movement Disorders Center, Department of Neurology, University Hospital of Bern, Switzerland
| | - Paul Krack
- Movement Disorders Center, Department of Neurology, University Hospital of Bern, Switzerland
| | - Elina Tripoliti
- UCL Queen Square Institute of Neurology, Department of Clinical and Movement Neurosciences, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, United Kingdom
| | - Evzen Ruzicka
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
| | - Robert Jech
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
| | - Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, and General University Hospital, Prague, Czech Republic
- Movement Disorders Center, Department of Neurology, University Hospital of Bern, Switzerland
| |
Collapse
|
22
|
Straccia G, Reale C, Castellani M, Colangelo I, Orunesu E, Meoni S, Moro E, Krack P, Prokisch H, Zech M, Romito LM, Garavaglia B. ACTB gene mutation in combined Dystonia-Deafness syndrome with parkinsonism: Expanding the phenotype and highlighting the long-term GPi DBS outcome. Parkinsonism Relat Disord 2022; 104:3-6. [PMID: 36183459 DOI: 10.1016/j.parkreldis.2022.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 01/09/2023]
Abstract
We report a Dystonia-Deafness syndrome patient treated by pallidal Deep Brain Stimulation with significant long-term benefits. Our study expands and confirms the complex phenotypic spectrum of ACTB gene-related disorders and supports the effectiveness of pallidal stimulation on motor outcomes and quality of life in dystonia due to ACTB p.Arg183Trp heterozygosity.
Collapse
Affiliation(s)
- Giulia Straccia
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Neurology and Stroke Unit, C.T.O. Hospital, A.O.R.N. "Ospedali dei Colli", Naples, Italy
| | - Chiara Reale
- Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Massimo Castellani
- Nuclear Medicine Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Isabel Colangelo
- Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eva Orunesu
- Nuclear Medicine Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Meoni
- Movement Disorders Unit, Division of Neurology, CHU Grenoble Alpes, Grenoble, France
| | - Elena Moro
- Movement Disorders Unit, Division of Neurology, CHU Grenoble Alpes, Grenoble, France
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Holger Prokisch
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Technical University of Munich, School of Medicine, Institute of Human Genetics, Munich, Germany
| | - Michael Zech
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Technical University of Munich, School of Medicine, Institute of Human Genetics, Munich, Germany
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - Barbara Garavaglia
- Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| |
Collapse
|
23
|
Nordenström S, Petermann K, Debove I, Nowacki A, Krack P, Pollo C, Nguyen TAK. Programming of subthalamic nucleus deep brain stimulation for Parkinson's disease with sweet spot-guided parameter suggestions. Front Hum Neurosci 2022; 16:925283. [PMID: 36393984 PMCID: PMC9663652 DOI: 10.3389/fnhum.2022.925283] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/30/2022] [Indexed: 10/24/2023] Open
Abstract
Deep Brain Stimulation (DBS) is an effective treatment for advanced Parkinson's disease. However, identifying stimulation parameters, such as contact and current amplitudes, is time-consuming based on trial and error. Directional leads add more stimulation options and render this process more challenging with a higher workload for neurologists and more discomfort for patients. In this study, a sweet spot-guided algorithm was developed that automatically suggested stimulation parameters. These suggestions were retrospectively compared to clinical monopolar reviews. A cohort of 24 Parkinson's disease patients underwent bilateral DBS implantation in the subthalamic nucleus at our center. First, the DBS' leads were reconstructed with the open-source toolbox Lead-DBS. Second, a sweet spot for rigidity reduction was set as the desired stimulation target for programming. This sweet spot and estimations of the volume of tissue activated were used to suggest (i) the best lead level, (ii) the best contact, and (iii) the effect thresholds for full therapeutic effect for each contact. To assess these sweet spot-guided suggestions, the clinical monopolar reviews were considered as ground truth. In addition, the sweet spot-guided suggestions for best lead level and best contact were compared against reconstruction-guided suggestions, which considered the lead location with respect to the subthalamic nucleus. Finally, a graphical user interface was developed as an add-on to Lead-DBS and is publicly available. With the interface, suggestions for all contacts of a lead can be generated in a few seconds. The accuracy for suggesting the best out of four lead levels was 56%. These sweet spot-guided suggestions were not significantly better than reconstruction-guided suggestions (p = 0.3). The accuracy for suggesting the best out of eight contacts was 41%. These sweet spot-guided suggestions were significantly better than reconstruction-guided suggestions (p < 0.001). The sweet spot-guided suggestions of each contact's effect threshold had a mean error of 1.2 mA. On an individual lead level, the suggestions can vary more with mean errors ranging from 0.3 to 4.8 mA. Further analysis is warranted to improve the sweet spot-guided suggestions and to account for more symptoms and stimulation-induced side effects.
Collapse
Affiliation(s)
- Simon Nordenström
- Department of Neurosurgery, University Hospital Bern, Bern, Switzerland
| | - Katrin Petermann
- Department of Neurology, University Hospital Bern, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, University Hospital Bern, Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, University Hospital Bern, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, University Hospital Bern, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, University Hospital Bern, Bern, Switzerland
| | - T. A. Khoa Nguyen
- Department of Neurosurgery, University Hospital Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University Bern, Bern, Switzerland
| |
Collapse
|
24
|
Hariz M, Bronstein JM, Cosgrove GR, de Bie RMA, DeLong MR, Gross RE, Krack P, Krauss JK, Lang AE, Lees AJ, Lozano AM, Obeso JA, Schuurman PR, Vitek JL. Concerns about the European Academy's Recommendations and Guidelines Regarding Pallidotomy for Parkinson's Disease. Eur J Neurol 2022; 30:1831-1833. [PMID: 36128760 DOI: 10.1111/ene.15569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/08/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Marwan Hariz
- Department of Clinical Neuroscience, Umeå University, Umeå, Sweden
- UCL Queen Square Institute of Neurology, London, UK
| | - Jeff M Bronstein
- Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - G Rees Cosgrove
- Neurosurgery Department, The Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Rob M A de Bie
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Mahlon R DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Robert E Gross
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Joachim K Krauss
- Department of Neurosurgery, Medical School Hannover, Hannover, Germany
| | - Anthony E Lang
- The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada
| | | | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - José A Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Fundación Hospitales de Madrid, HM Hospitales, Hospital Universitario HM Puerta del Sur, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- University CEU-San Pablo, Madrid, Spain
| | | | - Jerold L Vitek
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
25
|
Visser-Vandewalle V, Andrade P, Mosley PE, Greenberg BD, Schuurman R, McLaughlin NC, Voon V, Krack P, Foote KD, Mayberg HS, Figee M, Kopell BH, Polosan M, Joyce EM, Chabardes S, Matthews K, Baldermann JC, Tyagi H, Holtzheimer PE, Bervoets C, Hamani C, Karachi C, Denys D, Zrinzo L, Blomstedt P, Naesström M, Abosch A, Rasmussen S, Coenen VA, Schlaepfer TE, Dougherty DD, Domenech P, Silburn P, Giordano J, Lozano AM, Sheth SA, Coyne T, Kuhn J, Mallet L, Nuttin B, Hariz M, Okun MS. Deep brain stimulation for obsessive-compulsive disorder: a crisis of access. Nat Med 2022; 28:1529-1532. [PMID: 35840727 DOI: 10.1038/s41591-022-01879-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany.
| | - Pablo Andrade
- Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Philip E Mosley
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, and Queensland Brain Institute, Brisbane, Queensland, Australia
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Center for Neuromodulation, Butler Hospital, Providence, RI, USA.,RR&D Center for Neurorestoration and Neurotechnology, Providence, RI, USA
| | - Rick Schuurman
- Department of Neurosurgery, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Nicole C McLaughlin
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Behavioral Medicine and Addictions Research, Butler Hospital, Providence, Rhode Island, USA
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Kelly D Foote
- Department of Neurosurgery, University of Florida Health, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Brian H Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mircea Polosan
- Fondation Fondamental, Créteil, France.,Centre Expert Troubles Bipolaires, Service Universitaire de Psychiatrie, Centre Hospitalier Universitaire de Grenoble et des Alpes, Grenoble, France.,Grenoble Institut des Neurosciences, Inserm U 836, La Tronche, France
| | - Eileen M Joyce
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Stephan Chabardes
- Department of Neurosurgery, Grenoble University Hospital, Grenoble, France
| | - Keith Matthews
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, UK
| | - Juan C Baldermann
- Department of Neurology, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Himanshu Tyagi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Paul E Holtzheimer
- Departments of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Chris Bervoets
- Department of Neurosciences, Adult Psychiatry, UPC KU Leuven, Leuven, Belgium
| | - Clement Hamani
- Sunnybrook Research Institute, Division of Neurosurgery, University of Toronto, Toronto, Canada
| | - Carine Karachi
- Neurosurgery Department, Hôpital de la Salpêtrière, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Ludvic Zrinzo
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | | | - Matilda Naesström
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden
| | - Aviva Abosch
- Department of Neurosurgery and Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Steven Rasmussen
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.,Carney Institute for Brain Science, Brown University, Providence, RI, USA
| | - Volker A Coenen
- Department of Stereotactic and Functional Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Deep Brain Stimulation, Freiburg University, Freiburg, Germany
| | - Thomas E Schlaepfer
- Department of Stereotactic and Functional Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Deep Brain Stimulation, Freiburg University, Freiburg, Germany
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - Philippe Domenech
- Département Médico-Universitaire de Psychiatrie et d'Addictologie, Assistance Publique-Hôpitaux de Paris, Le Groupe Hospitalier Universitaire Henri Mondor, Université Paris-Est, Créteil, France.,Institut du Cerveau, Inserm U1127, CNRS UMR7225, Sorbonne Université, Paris, France
| | - Peter Silburn
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - James Giordano
- Department of Neurology, Georgetown University Medical Center, Washington, DC, USA.,Department of Biochemistry and Molecular & Cellular Biology, Georgetown University, Washington, DC, USA.,Neuroethics Studies Program, Pellegrino Center for Clinical Bioethics, Georgetown University, Washington, DC, USA
| | - Andres M Lozano
- Department of Neurosurgery and Neuroscience, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Terry Coyne
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, and Faculty of Medicine, University of Cologne, Cologne, Germany.,Department of Psychiatry, Psychotherapy, and Psychosomatics, Johanniter Hospital Oberhausen, Oberhausen, Germany
| | - Luc Mallet
- Département Médical-Universitaire de Psychiatrie et d'Addictologie, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris, University Paris-Est Créteil, Créteil, France.,Institut du Cerveau, Paris Brain Institute, Inserm, CNRS, Sorbonne Université, Paris, France.,Department of Mental Health and Psychiatry, Global Health Institute, University of Geneva, Geneva, Switzerland
| | - Bart Nuttin
- Department of Neurosurgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Marwan Hariz
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology and UCLH National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Unit for Deep Brain Stimulation, Umeå University, Umeå, Sweden
| | - Michael S Okun
- Department of Neurosurgery, University of Florida Health, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA.,Department of Neurology, University of Florida Health, Gainesville, FL, USA
| |
Collapse
|
26
|
Meira B, Lhommée E, Schmitt E, Klinger H, Bichon A, Pélissier P, Anheim M, Tranchant C, Fraix V, Meoni S, Durif F, Houeto JL, Azulay JP, Moro E, Thobois S, Krack P, Castrioto A. Early Parkinson's Disease Phenotypes Tailored by Personality, Behavior, and Motor Symptoms. J Parkinsons Dis 2022; 12:1665-1676. [PMID: 35527563 DOI: 10.3233/jpd-213070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous studies described a parkinsonian personality characterized as rigid, introverted, and cautious; however, little is known about personality traits in de novo Parkinson's disease (PD) patients and their relationships with motor and neuropsychiatric symptoms. OBJECTIVE To investigate personality in de novo PD and explore its relationship with PD symptoms. METHODS Using Cloninger's biosocial model, we assessed personality in 193 de novo PD patients. Motor and non-motor symptoms were measured using several validated scales. Cluster analysis was conducted to investigate the interrelationship of personality traits, motor, and non-motor symptoms. RESULTS PD patients showed low novelty seeking, high harm avoidance, and normal reward dependence and persistence scores. Harm avoidance was positively correlated with the severity of depression, anxiety, and apathy (rs = [0.435, 0.676], p < 0.001) and negatively correlated with quality of life (rs = -0.492, p < 0.001). Novelty seeking, reward dependence, and persistence were negatively correlated with apathy (rs = [-0.274, -0.375], p < 0.001). Classification of patients according to personality and PD symptoms revealed 3 distinct clusters: i) neuropsychiatric phenotype (with high harm avoidance and low novelty seeking, hypodopaminergic neuropsychiatric symptoms and higher impulsivity), ii) motor phenotype (with low novelty seeking and higher motor severity), iii) benign phenotype (with low harm avoidance and high novelty seeking, reward dependence, and persistence traits clustered with lower symptoms severity and low impulsivity). CONCLUSION Personality in early PD patients allows us to recognize 3 patients' phenotypes. Identification of such subgroups may help to better understand their natural history. Their longitudinal follow-up will allow confirming whether some personality features might influence disease evolution and treatment.
Collapse
Affiliation(s)
- Bruna Meira
- Neurology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.,Movement Disorders Center, Neurology, CHU Grenoble Alpes, Grenoble, France
| | - Eugénie Lhommée
- Movement Disorders Center, Neurology, CHU Grenoble Alpes, Grenoble, France
| | - Emmanuelle Schmitt
- Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Hélène Klinger
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Neurologie C, Centre Expert Parkinson, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, CNRS, Institut des Sciences Cognitives Marc Jeannerod, Bron, France
| | - Amélie Bichon
- Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Pierre Pélissier
- Movement Disorders Center, Neurology, CHU Grenoble Alpes, Grenoble, France
| | - Mathieu Anheim
- Département de Neurologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire, (IGBMC), INSERM-U964/CNRS-UMR7104/, Université de Strasbourg, Illkirch, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Christine Tranchant
- Département de Neurologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire, (IGBMC), INSERM-U964/CNRS-UMR7104/, Université de Strasbourg, Illkirch, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Valérie Fraix
- Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Sara Meoni
- Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Franck Durif
- Université Clermont Auvergne, NPsy-Sydo, Clermont-Ferrand University Hospital, Neurology Department, Clermont-Ferrand, France
| | - Jean-Luc Houeto
- Service de Neurologie, Centre Expert Parkinson, CHU de Limoges, UMR1094 INSERM, Université de Limoges, Limoges, France
| | - Jean Philippe Azulay
- Neurology and Pathology Department of the Movement, University Hospital of Marseille, Timone Hospital, Marseille, France
| | - Elena Moro
- Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Stéphane Thobois
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Neurologie C, Centre Expert Parkinson, Lyon, France.,Univ Lyon, Université Claude Bernard Lyon 1, CNRS, Institut des Sciences Cognitives Marc Jeannerod, Bron, France
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Anna Castrioto
- Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | | |
Collapse
|
27
|
Castrioto A, Debû B, Cousin E, Pelissier P, Lhommée E, Bichon A, Schmitt E, Kistner A, Meoni S, Seigneuret E, Chabardes S, Krack P, Moro E, Fraix V. Long-term independence and quality of life after subthalamic stimulation in Parkinson's disease. Eur J Neurol 2022; 29:2645-2653. [PMID: 35666167 PMCID: PMC9543065 DOI: 10.1111/ene.15436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/19/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022]
Abstract
Background and purpose Studies on long‐term nonmotor outcomes of subthalamic nucleus stimulation in Parkinson disease (PD) are scarce. This study reports on very long‐term non‐motor and motor outcomes in one of the largest cohorts of people with advanced PD, treated for >10 years with subthalamic nucleus stimulation. The main outcome was to document the evolution of independence in activities of daily living. The secondary outcomes were to measure the change in quality of life, as well as non‐motor and motor outcomes. Methods Patients were studied preoperatively, at 1 year, and beyond 10 years after subthalamic stimulation with an established protocol including motor, non‐motor, and neuropsychological assessments. Results Eighty‐five people with PD were included. Independence scores in the off‐medication condition (measured with the Schwab & England Activities of Daily Living Scale) as well as quality of life (measured with the Parkinson's Disease Questionnaire [PDQ]‐37) remained improved at longest follow‐up compared to preoperatively (respectively, p < 0.001, p = 0.015). Cognitive scores, measured with the Mattis Dementia Rating Scale, significantly worsened compared to before and 1 year after surgery (p < 0.001), without significant change in depression, measured with the Beck Depression Inventory. Motor fluctuations, dyskinesias, and off dystonia remained improved at longest follow‐up (p < 0.001), with a significant reduction in dopaminergic treatment (45%, p < 0.001). Conclusions This study highlights the long‐term improvement of subthalamic stimulation on independence and quality of life, despite the progression of disease and the occurrence of levodopa‐resistant symptoms.
Collapse
Affiliation(s)
- Anna Castrioto
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Bettina Debû
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Emilie Cousin
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France.,Univ. Grenoble Alpes, UMS IRMaGe CHU Grenoble, 38000, Grenoble, France
| | - Pierre Pelissier
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Eugénie Lhommée
- Movement disorders Center, Neurology, CHU Grenoble Alpes, Grenoble, France
| | - Amélie Bichon
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Emmanuelle Schmitt
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Andrea Kistner
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Sara Meoni
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Eric Seigneuret
- Department of Neurosurgery, CHU Grenoble Alpes, Grenoble, France
| | - Stephan Chabardes
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, Bern
| | - Elena Moro
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Valérie Fraix
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
| |
Collapse
|
28
|
Béreau M, Castrioto A, Servant M, Thobois S, Tranchant C, Krack P, Anheim M. Latéralisation des signes moteurs et troubles motivationnels dans la maladie de Parkinson de novo. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
29
|
Prange S, Metereau E, Maillet A, Klinger H, Schmitt E, Lhommée E, Bichon A, Lancelot S, Meoni S, Broussolle E, Castrioto A, Tremblay L, Krack P, Thobois S. Limbic Serotonergic Plasticity Contributes to the Compensation of Apathy in Early Parkinson's Disease. Mov Disord 2022; 37:1211-1221. [PMID: 35238430 DOI: 10.1002/mds.28971] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND De novo Parkinson's disease (PD) patients with apathy exhibit prominent limbic serotonergic dysfunction and microstructural disarray. Whether this distinctive lesion profile at diagnosis entails different prognosis remains unknown. OBJECTIVES To investigate the progression of dopaminergic and serotonergic dysfunction and their relation to motor and nonmotor impairment in PD patients with or without apathy at diagnosis. METHODS Thirteen de novo apathetic and 13 nonapathetic PD patients were recruited in a longitudinal double-tracer positron emission tomography cohort study. We quantified the progression of presynaptic dopaminergic and serotonergic pathology using [11 C]PE2I for dopamine transporter and [11 C]DASB for serotonin transporter at baseline and 3 to 5 years later, using linear mixed-effect models and mediation analysis to compare the longitudinal evolution between groups for clinical impairment and region-of-interest-based analysis. RESULTS After the initiation of dopamine replacement therapy, apathy, depression, and anxiety improved at follow-up in patients with apathy at diagnosis (n = 10) to the level of patients without apathy (n = 11). Patients had similar progression of motor impairment, whereas mild impulsive behaviors developed in both groups. Striato-pallidal and mesocorticolimbic presynaptic dopaminergic loss progressed similarly in both groups, as did serotonergic pathology in the putamen, caudate nucleus, and pallidum. Contrastingly, serotonergic innervation selectively increased in the ventral striatum and anterior cingulate cortex in apathetic patients, contributing to the reversal of apathy besides dopamine replacement therapy. CONCLUSION Patients suffering from apathy at diagnosis exhibit compensatory changes in limbic serotonergic innervation within 5 years of diagnosis, with promising evidence that serotonergic plasticity contributes to the reversal of apathy. The relationship between serotonergic plasticity and dopaminergic treatments warrants further longitudinal investigations. © 2022 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Stéphane Prange
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France.,Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Elise Metereau
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France.,Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Audrey Maillet
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France
| | - Hélène Klinger
- Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Emmanuelle Schmitt
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Eugénie Lhommée
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Amélie Bichon
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Sophie Lancelot
- CNRS UMR5292, INSERM U1028, Univ. Lyon 1, Lyon Neuroscience Research Center, Université de Lyon, Lyon, France.,Hospices Civils de Lyon, Lyon, France.,CERMEP-Imaging Platform, Groupement Hospitalier Est, Bron, France
| | - Sara Meoni
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Emmanuel Broussolle
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France.,Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France.,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon 1, Oullins, France
| | - Anna Castrioto
- Inserm, U1216, CHU Grenoble Alpes, Unité Troubles du Mouvement, Grenoble Institut Neurosciences, Univ. Grenoble Alpes, Grenoble, France
| | - Léon Tremblay
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France
| | - Paul Krack
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Stéphane Thobois
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Univ Lyon, Bron, France.,Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN Network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France.,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon 1, Oullins, France
| |
Collapse
|
30
|
Tödt I, Al-Fatly B, Granert O, Kühn AA, Krack P, Rau J, Timmermann L, Schnitzler A, Paschen S, Helmers AK, Hartmann A, Bardinet E, Schuepbach M, Barbe MT, Dembek TA, Fraix V, Kübler D, Brefel-Courbon C, Gharabaghi A, Wojtecki L, Pinsker MO, Thobois S, Damier P, Witjas T, Houeto JL, Schade-Brittinger C, Vidailhet M, Horn A, Deuschl G. The Contribution of Subthalamic Nucleus Deep Brain Stimulation to the Improvement in Motor Functions and Quality of Life. Mov Disord 2022; 37:291-301. [PMID: 35112384 DOI: 10.1002/mds.28952] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Subthalamic nucleus deep brain stimulation (STN-DBS) effectively treats motor symptoms and quality of life (QoL) of advanced and fluctuating early Parkinson's disease. Little is known about the relation between electrode position and changes in symptom control and ultimately QoL. OBJECTIVES The relation between the stimulated part of the STN and clinical outcomes, including the motor score of the Unified Parkinson's Disease Rating Scale (UPDRS) and the quality-of-life questionnaire, was assessed in a subcohort of the EARLYSTIM study. METHODS Sixty-nine patients from the EARLYSTIM cohort who underwent DBS, with a comprehensive clinical characterization before and 24 months after surgery, were included. Intercorrelations of clinical outcome changes, correlation between the affected functional parts of the STN, and changes in clinical outcomes were investigated. We further calculated sweet spots for different clinical parameters. RESULTS Improvements in the UPDRS III and Parkinson's Disease Questionnaire (PDQ-39) correlated positively with the extent of the overlap with the sensorimotor STN. The sweet spots for the UPDRS III (x = 11.6, y = -13.1, z = -6.3) and the PDQ-39 differed (x = 14.8, y = -12.4, z = -4.3) ~3.8 mm. CONCLUSIONS The main influence of DBS on QoL is likely mediated through the sensory-motor basal ganglia loop. The PDQ sweet spot is located in a posteroventral spatial location in the STN territory. For aspects of QoL, however, there was also evidence of improvement through stimulation of the other STN subnuclei. More research is necessary to customize the DBS target to individual symptoms of each patient. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Inken Tödt
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Bassam Al-Fatly
- Department of Neurology, Movement Disorders and Neuromodulation Section, Charité Medicine University of Berlin, Berlin, Germany
| | - Oliver Granert
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Andrea A Kühn
- Department of Neurology, Movement Disorders and Neuromodulation Section, Charité Medicine University of Berlin, Berlin, Germany
| | - Paul Krack
- Department of Neurology, University Hospital Bern and University of Bern, Bern, Switzerland
| | - Joern Rau
- Coordinating Center for Clinical Trials, Philipps-University, Marburg, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany
| | - Alfons Schnitzler
- Department of Neurology, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - Steffen Paschen
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Ann-Kristin Helmers
- Department of Neurosurgery, University Hospital Schleswig Holstein, Kiel, Germany
| | - Andreas Hartmann
- Assistance-Publique Hôpitaux de Paris, Center d'Investigation Clinique 9503, Institut du Cerveau et de la Moelle épinière, Paris, France.,Département de Neurologie, Université Pierre et Marie Curie-Paris 6 et INSERM, Paris, France
| | - Eric Bardinet
- Department of Neurology, NS-PARK/F-CRIN, University Hospital of Besançon, Besançon, France.,Center de Neuroimagerie de Recherche, Institut du Cerveau et de la Moelle (ICM), Paris, France
| | - Michael Schuepbach
- Department of Neurology, University Hospital Bern and University of Bern, Bern, Switzerland.,Assistance-Publique Hôpitaux de Paris, Center d'Investigation Clinique 9503, Institut du Cerveau et de la Moelle épinière, Paris, France.,Département de Neurologie, Université Pierre et Marie Curie-Paris 6 et INSERM, Paris, France.,Institute of Neurology, Konolfingen, Switzerland
| | - Michael T Barbe
- Department of Neurology, University of Cologne, Faculty of Medicine, Cologne, Germany
| | - Till A Dembek
- Department of Neurology, University of Cologne, Faculty of Medicine, Cologne, Germany
| | - Valerie Fraix
- Université Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France.,Neurology Department, Grenoble University Hospital, Grenoble, France
| | - Dorothee Kübler
- Department of Neurology, Movement Disorders and Neuromodulation Section, Charité Medicine University of Berlin, Berlin, Germany
| | | | - Alireza Gharabaghi
- Department of Neurosurgery and Neurotechnology Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tuebingen, Tuebingen, Germany
| | - Lars Wojtecki
- Department of Neurology and Neurorehabilitation, Hospital zum Heiligen Geist GmbH & Co.KG Academic Teaching Hospital of the Heinrich-Heine-University Düsseldorf Von-Broichhausen-Allee 1, Kempen, Germany
| | - Marcus O Pinsker
- Department of Neurosurgery, University of Freiburg, Freiburg, Germany
| | - Stephane Thobois
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Center Expert Parkinson, Bron, France.,Université Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux, Oullins, France
| | | | - Tatiana Witjas
- Department of Neurology, Timone University Hospital UMR 7289, CNRS Marseille, Marseille, France
| | - Jean-Luc Houeto
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Center Expert Parkinson, Bron, France
| | | | - Marie Vidailhet
- Department of Neurology, Sorbonne Université, ICM UMR1127, INSERM &1127, CNRS 7225, Salpêtriere University Hospital AP-HP, Paris, France
| | - Andreas Horn
- Department of Neurology, Movement Disorders and Neuromodulation Section, Charité Medicine University of Berlin, Berlin, Germany
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| |
Collapse
|
31
|
Béreau M, Castrioto A, Lhommée E, Maillet A, Gérazime A, Bichon A, Pélissier P, Schmitt E, Klinger H, Longato N, Fraix V, Benatru I, Durif F, Azulay JP, Moro E, Broussolle E, Tranchant C, Anheim M, Thobois S, Krack P. Fatigue in de novo Parkinson's Disease: Expanding the Neuropsychiatric Triad? J Parkinsons Dis 2022; 12:1329-1337. [PMID: 35253781 DOI: 10.3233/jpd-213116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Fatigue is a frequent and troublesome symptom present from the early stages of Parkinson's disease (PD). OBJECTIVE To examine the relationship between fatigue and the neuropsychiatric triad, which includes apathy, depression, and anxiety, in de novo PD. METHODS We performed a cross-sectional study including 197 patients with de novo PD and assessed fatigue using the Parkinson's Disease Fatigue Scale (PDFS-16). We evaluated motor status using the Unified Parkinson's Disease Rating Scale (UPDRS) part III score and evaluated neuropsychiatric status using the Ardouin Scale of Behavior in Parkinson's Disease (ASBPD). We carried out univariate and multivariate analyses to model association between motor signs, non-motor signs, and fatigue risk. RESULTS Frequency of fatigue (28.9%) was of the same order of magnitude as that of apathy. PD patients with fatigue reported a lower quality of life than patients without fatigue (p < 0.0001). The ASBPD showed that patients with fatigue had higher scores for depressed mood (p < 0.0001), anxiety (p < 0.0001), and apathy (p < 0.0001). In the univariate analysis, fatigue score was positively correlated with apathy, depression, anxiety, and the neuropsychiatric triad as a whole, and to a lesser extent with female sex, hyperemotivity, and the UPDRS part III score. In the multivariate analysis, after adjusting for sex and motor status, the fatigue score remained significantly correlated with apathy (OR = 11.17 [4.33-28.78], p < 0.0001) and depression (OR = 4.28 [1.39-13.12], p = 0.01), but not with anxiety (OR = 0.94 [0.34-2.58], p = 0.9). CONCLUSION We propose that the neuropsychiatric triad could be expanded to include fatigue.
Collapse
Affiliation(s)
- Matthieu Béreau
- Department of Neurology, University Hospital of Besançon, Besançon, France
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche-Comté, Besançon, France
- NS-PARK/FCRIN Network, France
| | - Anna Castrioto
- University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Movement Disorders Unit, Grenoble Institut Neurosciences, Grenoble, France
| | - Eugénie Lhommée
- University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Movement Disorders Unit, Grenoble Institut Neurosciences, Grenoble, France
| | - Audrey Maillet
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, University Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Aurélie Gérazime
- Unité de Méthodologie, CIC INSERM 1431, CHRU de Besançon, Besançon, France
| | - Amélie Bichon
- University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Movement Disorders Unit, Grenoble Institut Neurosciences, Grenoble, France
| | - Pierre Pélissier
- University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Movement Disorders Unit, Grenoble Institut Neurosciences, Grenoble, France
| | - Emmanuelle Schmitt
- University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Movement Disorders Unit, Grenoble Institut Neurosciences, Grenoble, France
| | - Hélène Klinger
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, University Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Nadine Longato
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Valérie Fraix
- University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Movement Disorders Unit, Grenoble Institut Neurosciences, Grenoble, France
| | - Isabelle Benatru
- Department of Neurology, University Hospital of Poitiers, Poitiers, France
- INSERM, CHU de Poitiers, University of Poitiers, Centre d'Investigation Clinique CIC1402, Poitiers, France
| | - Franck Durif
- Neurology Department, Université Clermont Auvergne, EA7280 NPsy-Sydo, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Jean-Philippe Azulay
- Movement Disorders Unit, Neurology Department, University Hospital of Marseille, Marseille, France
| | - Elena Moro
- University Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Movement Disorders Unit, Grenoble Institut Neurosciences, Grenoble, France
| | - Emmanuel Broussolle
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, University Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Stéphane Thobois
- NS-PARK/FCRIN Network, France
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, University Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Paul Krack
- Movement Disorders Center, Department of Neurology, University Hospital of Bern, Bern, Switzerland
| |
Collapse
|
32
|
Stieglitz LH, Oertel MF, Accolla EA, Bally J, Bauer R, Baumann CR, Benninger D, Bohlhalter S, Büchele F, Hägele-Link S, Kägi G, Krack P, Krüger MT, Mahendran S, Möller JC, Mylius V, Piroth T, Werner B, Kaelin-Lang A. Consensus Statement on High-Intensity Focused Ultrasound for Functional Neurosurgery in Switzerland. Front Neurol 2021; 12:722762. [PMID: 34630296 PMCID: PMC8493868 DOI: 10.3389/fneur.2021.722762] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Magnetic resonance-guided high-intensity focused ultrasound (MRgHiFUS) has evolved into a viable ablative treatment option for functional neurosurgery. However, it is not clear yet, how this new technology should be integrated into current and established clinical practice and a consensus should be found about recommended indications, stereotactic targets, patient selection, and outcome measurements. Objective: To sum up and unify current knowledge and clinical experience of Swiss neurological and neurosurgical communities regarding MRgHiFUS interventions for brain disorders to be published as a national consensus paper. Methods: Eighteen experienced neurosurgeons and neurologists practicing in Switzerland in the field of movement disorders and one health physicist representing 15 departments of 12 Swiss clinical centers and 5 medical societies participated in the workshop and contributed to the consensus paper. All experts have experience with current treatment modalities or with MRgHiFUS. They were invited to participate in two workshops and consensus meetings and one online meeting. As part of workshop preparations, a thorough literature review was undertaken and distributed among participants together with a list of relevant discussion topics. Special emphasis was put on current experience and practice, and areas of controversy regarding clinical application of MRgHiFUS for functional neurosurgery. Results: The recommendations addressed lesioning for treatment of brain disorders in general, and with respect to MRgHiFUS indications, stereotactic targets, treatment alternatives, patient selection and management, standardization of reporting and follow-up, and initialization of a national registry for interventional therapies of movement disorders. Good clinical evidence is presently only available for unilateral thalamic lesioning in treating essential tremor or tremor-dominant Parkinson's disease and, to a minor extent, for unilateral subthalamotomy for Parkinson's disease motor features. However, the workgroup unequivocally recommends further exploration and adaptation of MRgHiFUS-based functional lesioning interventions and confirms the need for outcome-based evaluation of these approaches based on a unified registry. MRgHiFUS and DBS should be evaluated by experts familiar with both methods, as they are mutually complementing therapy options to be appreciated for their distinct advantages and potential. Conclusion: This multidisciplinary consensus paper is a representative current recommendation for safe implementation and standardized practice of MRgHiFUS treatments for functional neurosurgery in Switzerland.
Collapse
Affiliation(s)
| | - Markus F Oertel
- Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
| | - Ettore A Accolla
- Neurology Unit, Department of Internal Medicine, Hôpital Fribourgeois (HFR)-Cantonal Hospital Fribourg, University of Fribourg, Fribourg, Switzerland
| | - Julien Bally
- Department of Neurology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland
| | - Roland Bauer
- Department of Neurosurgery, Cantonal Hospital Aarau, Aarau, Switzerland
| | | | - David Benninger
- Department of Neurology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Stephan Bohlhalter
- Neurocenter, Lucerne Cantonal Hospital, University of Zurich, Zurich, Switzerland
| | - Fabian Büchele
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Stefan Hägele-Link
- Department of Neurology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Georg Kägi
- Department of Neurology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Paul Krack
- Department of Neurology, Inselspital, University Bern, Bern, Switzerland
| | - Marie T Krüger
- Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Sujitha Mahendran
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - J Carsten Möller
- Parkinson Center, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Veit Mylius
- Department of Neurology, Center for Neurorehabilitation, Valens, Switzerland
| | - Tobias Piroth
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Beat Werner
- Center for Magnetic Resonance (MR) Research, University Children's Hospital Zurich, Zurich, Switzerland
| | - Alain Kaelin-Lang
- Department of Neurology, Inselspital, University Bern, Bern, Switzerland.,Neurocenter of Southern Switzerland Ente Ospedaliero Cantonale (EOC), Regional Hospital Lugano, Lugano, Switzerland.,Faculty of Biomedical Neurosciences, Università Della Svizzera Italiana, Lugano, Switzerland
| |
Collapse
|
33
|
Maillet A, Météreau E, Tremblay L, Favre E, Klinger H, Lhommée E, Le Bars D, Castrioto A, Prange S, Sgambato V, Broussolle E, Krack P, Thobois S. Serotonergic and Dopaminergic Lesions Underlying Parkinsonian Neuropsychiatric Signs. Mov Disord 2021; 36:2888-2900. [PMID: 34494685 DOI: 10.1002/mds.28722] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/29/2021] [Accepted: 06/14/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is characterized by heterogeneous motor and nonmotor manifestations related to alterations in monoaminergic neurotransmission systems. Nevertheless, the characterization of concomitant dopaminergic and serotonergic dysfunction after different durations of Parkinson's disease, as well as their respective involvement in the expression and severity of neuropsychiatric signs, has gained little attention so far. METHODS To fill this gap, we conducted a cross-sectional study combining clinical and dual-tracer positron emission tomography (PET) neuroimaging approaches, using radioligands of dopamine ([11 C]-N-(3-iodoprop-2E-enyl)-2-beta-carbomethoxy-3-beta-(4-methylphenyl)-nortropane) ([11 C]PE2I) and serotonin ([11 C]-N,N-dimethyl-2-(-2-amino-4-cyanophenylthio)-benzylamine) ([11 C]DASB) reuptake, after different durations of Parkinson's disease (ie, in short-disease duration drug-naive de novo (n = 27, 0-2 years-duration), suffering from apathy (n = 14) or not (n = 13); intermediate-disease duration (n = 15, 4-7 years-duration) and long-disease duration, non-demented (n = 15, 8-10 years-duration) patients). Fifteen age-matched healthy subjects were also enrolled. RESULTS The main findings are threefold: (1) both dopaminergic and serotonergic lesions worsen with the duration of Parkinson's disease, spreading from midbrain/subcortical to cortical regions; (2) the presence of apathy at PD onset is associated with more severe cortical and subcortical serotonergic and dopaminergic disruption, similar to the denervation pattern observed in intermediate-disease duration patients; and (3) the severity of parkinsonian apathy, depression, and trait-anxiety appears primarily related to serotonergic alteration within corticostriatal limbic areas. CONCLUSIONS Altogether, these findings highlight the prominent role of serotonergic degeneration in the expression of several neuropsychiatric symptoms occurring after different durations of Parkinson's disease. © 2021 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Audrey Maillet
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Lyon, France.,Université Claude Bernard Lyon I, Lyon, France
| | - Elise Météreau
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Lyon, France.,Université Claude Bernard Lyon I, Lyon, France.,Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Lyon, France
| | - Léon Tremblay
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Lyon, France.,Université Claude Bernard Lyon I, Lyon, France
| | - Emilie Favre
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Lyon, France.,Genopsy, Centre Hospitalier Le Vinatier, Lyon, France
| | - Hélène Klinger
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Lyon, France
| | - Eugénie Lhommée
- Université Grenoble Alpes, Grenoble Institut des Neurosciences, Inserm U1216, Grenoble, France.,Unité des Troubles du Mouvement, Département de Neurologie, CHU de Grenoble, Grenoble, France
| | - Didier Le Bars
- CERMEP, Imagerie du Vivant, Lyon, France.,Institut de Chimie et de Biochimie Moléculaires et Supramoléculaires, UMR 5246 CNRS, Université Claude Bernard Lyon I, Lyon, France
| | - Anna Castrioto
- Université Grenoble Alpes, Grenoble Institut des Neurosciences, Inserm U1216, Grenoble, France.,Unité des Troubles du Mouvement, Département de Neurologie, CHU de Grenoble, Grenoble, France
| | - Stéphane Prange
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Lyon, France.,Université Claude Bernard Lyon I, Lyon, France.,Faculté de médecine Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon I, Lyon, France
| | - Véronique Sgambato
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Lyon, France.,Université Claude Bernard Lyon I, Lyon, France
| | - Emmanuel Broussolle
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Lyon, France.,Université Claude Bernard Lyon I, Lyon, France.,Faculté de médecine Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon I, Lyon, France
| | - Paul Krack
- Université Grenoble Alpes, Grenoble Institut des Neurosciences, Inserm U1216, Grenoble, France.,Unité des Troubles du Mouvement, Département de Neurologie, CHU de Grenoble, Grenoble, France.,Department of Neurology, Center for Parkinson's Disease and Movement Disorders, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stéphane Thobois
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Lyon, France.,Université Claude Bernard Lyon I, Lyon, France.,Faculté de médecine Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon I, Lyon, France
| |
Collapse
|
34
|
Lachenmayer ML, Mürset M, Antih N, Debove I, Muellner J, Bompart M, Schlaeppi JA, Nowacki A, You H, Michelis JP, Dransart A, Pollo C, Deuschl G, Krack P. Subthalamic and pallidal deep brain stimulation for Parkinson's disease-meta-analysis of outcomes. NPJ Parkinsons Dis 2021; 7:77. [PMID: 34489472 PMCID: PMC8421387 DOI: 10.1038/s41531-021-00223-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 08/12/2021] [Indexed: 12/26/2022]
Abstract
Although deep brain stimulation (DBS) of the globus pallidus internus (GPi) and the subthalamic nucleus (STN) has become an established treatment for Parkinson’s disease (PD), a recent meta-analysis of outcomes is lacking. To address this gap, we performed a meta-analysis of bilateral STN- and GPi-DBS studies published from 1990-08/2019. Studies with ≥10 subjects reporting Unified Parkinson’s Disease Rating Scale (UPDRS) III motor scores at baseline and 6–12 months follow-up were included. Several outcome variables were analyzed and adverse events (AE) were summarized. 39 STN studies (2035 subjects) and 5 GPi studies (292 subjects) were eligible. UPDRS-II score after surgery in the stimulation-ON/medication-OFF state compared to preoperative medication-OFF state improved by 47% with STN-DBS and 18.5% with GPi-DBS. UPDRS-III score improved by 50.5% with STN-DBS and 29.8% with GPi-DBS. STN-DBS improved dyskinesia by 64%, daily OFF time by 69.1%, and quality of life measured by PDQ-39 by 22.2%, while Levodopa Equivalent Daily Dose (LEDD) was reduced by 50.0%. For GPi-DBS information regarding dyskinesia, OFF time, PDQ-39 and LEDD was insufficient for further analysis. Correlation analysis showed that preoperative L-dopa responsiveness was highly predictive of the STN-DBS motor outcome across all studies. Most common surgery-related AE were infection (5.1%) and intracranial hemorrhage (3.1%). Despite a series of technological advances, outcomes of modern surgery are still comparable with those of the early days of DBS. Recent changes in target selection with a preference of GPi in elderly patients with cognitive deficits and more psychiatric comorbidities require more published data for validation.
Collapse
Affiliation(s)
- M Lenard Lachenmayer
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Melina Mürset
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Ines Debove
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Julia Muellner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Janine-Ai Schlaeppi
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hana You
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Joan P Michelis
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Claudio Pollo
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Guenther Deuschl
- Department of Neurology, UKSH, Christian-Albrechts-University, Kiel, Germany
| | - Paul Krack
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
35
|
Piscicelli C, Castrioto A, Jaeger M, Fraix V, Chabardes S, Moro E, Krack P, Debû B, Pérennou D. Contribution of Basal Ganglia to the Sense of Upright: A Double-Blind Within-Person Randomized Trial of Subthalamic Stimulation in Parkinson's Disease with Pisa Syndrome. J Parkinsons Dis 2021; 11:1393-1408. [PMID: 33896847 DOI: 10.3233/jpd-202388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Verticality perception is frequently altered in Parkinson's disease (PD) with Pisa syndrome (PS). Is it the cause or the consequence of the PS? OBJECTIVE We tested the hypothesis that both scenarios coexist. METHODS We performed a double-blind within-person randomized trial (NCT02704910) in 18 individuals (median age 63.5 years) with PD evolving for a median of 17.5 years and PS for 2.5 years and treated with bilateral stimulation of the subthalamus nuclei (STN-DBS) for 6.5 years. We analyzed whether head and trunk orientations were congruent with the visual (VV) and postural (PV) vertical, and whether switching on one or both sides of the STN-DBS could modulate trunk orientation via verticality representation. RESULTS The tilted verticality perception could explain the PS in 6/18 (33%) patients, overall in three right-handers (17%) who showed net and congruent leftward trunk and PV tilts. Two of the 18 (11%) had an outstanding clinical picture associating leftward: predominant parkinsonian symptoms, whole-body tilt (head -11°, trunk -8°) and transmodal tilt in verticality perception (PV -10°, VV -8.9°). Trunk orientation or VV were not modulated by STN-DBS, whereas PV tilts were attenuated by unilateral or bilateral stimulations if it was applied on the opposite STN. CONCLUSION In most cases of PS, verticality perception is altered by the body deformity. In some cases, PS seems secondary to a biased internal model of verticality, and DBS on the side of the most denervated STN attenuated PV tilts with a quasi-immediate effect. This is an interesting track for further clinical studies.
Collapse
Affiliation(s)
- Céline Piscicelli
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
| | - Anna Castrioto
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Marie Jaeger
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France
| | - Valerie Fraix
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Stephan Chabardes
- Department of Neurosurgery, Grenoble-Alpes University Hospital, Grenoble, France
| | - Elena Moro
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Paul Krack
- Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland
| | - Bettina Debû
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Dominic Pérennou
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
| |
Collapse
|
36
|
Schedlich-Teufer C, Jost ST, Krack P, Witt K, Weintraub D, Baldermann JC, Sommerauer M, Amstutz D, van Eimeren T, Dafsari HS, Kalbe E, Visser-Vandewalle V, Fink GR, Kessler J, Barbe MT. Assessment of Affective-Behavioral States in Parkinson's Disease Patients: Towards a New Screening Tool. J Parkinsons Dis 2021; 11:1417-1430. [PMID: 33967055 DOI: 10.3233/jpd-202375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Assessment of affective-behavioral states in patients with Parkinson's disease (PD) undergoing deep brain stimulation (DBS) is essential. OBJECTIVE To analyze well-established questionnaires as a pilot-study with the long term aim to develop a screening tool evaluating affective-behavioral dysfunction, including depression, anxiety, apathy, mania, and impulse control disorders, in PD patients screened for DBS. METHODS Two hundred ninety-seven inpatients with PD underwent standardized neuropsychiatric testing including German versions of Beck Depression Inventory-II, Hospital Anxiety and Depression Scale, Apathy Evaluation Scale, Self-Report Manic Inventory, and Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale, to assess appropriateness for DBS. Statistical item reduction was based on exploratory factor analysis, Cronbach's alpha, item-total correlations, item difficulty, and inter-item correlations. Confirmatory factor analysis was conducted to assess factorial validity. An expert rating was performed to identify clinically relevant items in the context of PD and DBS, to maintain content validity. We compared the shortened subscales with the original questionnaires using correlations. To determine cutoff points, receiver operating characteristics analysis was performed. RESULTS The items of the initial questionnaires were reduced from 129 to 38 items. Results of confirmatory factor analyses supported the validity of the shortened pool. It demonstrated high internal consistency (Cronbach's alpha = 0.72-0.83 across subscales), and the individual subscales were correlated with the corresponding original scales (rs = 0.84-0.95). Sensitivities and specificities exceeded 0.7. CONCLUSION The shortened item pool, including 38 items, provides a good basis for the development of a screening tool, capturing affective-behavioral symptoms in PD patients before DBS implantation. Confirmation of the validity of such a screening tool in an independent sample of PD patients is warranted.
Collapse
Affiliation(s)
- Charlotte Schedlich-Teufer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stefanie Theresa Jost
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Karsten Witt
- Department of Neurology, School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | - Daniel Weintraub
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Juan Carlos Baldermann
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Sommerauer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Deborah Amstutz
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Thilo van Eimeren
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany
| | - Haidar Salimi Dafsari
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gereon Rudolf Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
| | - Josef Kessler
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Thomas Barbe
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| |
Collapse
|
37
|
Bove F, Mulas D, Cavallieri F, Castrioto A, Chabardès S, Meoni S, Schmitt E, Bichon A, Di Stasio E, Kistner A, Pélissier P, Chevrier E, Seigneuret E, Krack P, Fraix V, Moro E. Long-term Outcomes (15 Years) After Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease. Neurology 2021; 97:e254-e262. [PMID: 34078713 DOI: 10.1212/wnl.0000000000012246] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/13/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) on motor complications in patients with Parkinson disease (PD) beyond 15 years after surgery. METHODS Data on motor complications, quality of life (QoL), activities of daily living, Unified Parkinson's Disease Rating Scale motor scores, dopaminergic treatment, stimulation measures, and side effects of STN-DBS were retrospectively retrieved and compared before surgery, at 1 year, and beyond 15 years after bilateral STN-DBS. RESULTS Fifty-one patients with 17.06 ± 2.18 years STN-DBS follow-up were recruited. Compared to baseline, the time spent with dyskinesia and the time spent in the "off" state were reduced by 75% (p < 0.001) and by 58.7% (p < 0.001), respectively. Moreover, dopaminergic drugs were reduced by 50.6% (p < 0.001). Parkinson's Disease Quality of Life Questionnaire total score and the emotional function and social function domains improved 13.8% (p = 0.005), 13.6% (p = 0.01), and 29.9% (p < 0.001), respectively. Few and mostly manageable device-related adverse events were observed during the follow-up. CONCLUSIONS STN-DBS is effective beyond 15 years from the intervention, notably with significant improvement in motor complications and stable reduction of dopaminergic drugs. Furthermore, despite the natural continuous progression of PD with worsening of levodopa-resistant motor and nonmotor symptoms over the years, patients undergoing STN-DBS could maintain an improvement in QoL. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that, for patients with PD, STN-DBS remains effective at treating motor complications 15 years after surgery.
Collapse
Affiliation(s)
- Francesco Bove
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Delia Mulas
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Francesco Cavallieri
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Anna Castrioto
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Stephan Chabardès
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Sara Meoni
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Emmanuelle Schmitt
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Amélie Bichon
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Enrico Di Stasio
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Andrea Kistner
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Pierre Pélissier
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Eric Chevrier
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Eric Seigneuret
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Paul Krack
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Valerie Fraix
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland
| | - Elena Moro
- From the Movement Disorders Unit, Division of Neurology (F.B., D.M., F.C., A.C., S.M., E.S., A.B., A.K., P.P., E.C., V.F., E.M.), CHU Grenoble Alpes, Grenoble, France; Neurology Unit (F.B.) and Chemistry, Biochemistry and Clinical Molecular Biology (E.D.S.), Fondazione Policlinico Universitario A. Gemelli IRCCS; Department of Neurosciences (F.B.) and Institute of Biochemistry and Clinical Biochemistry (E.D.S.), Università Cattolica del Sacro Cuore, Rome; Institute of Neurology (D.M.), Mater Olbia Hospital, Olbia; Neurology Unit, Neuromotor and Rehabilitation Department (F.C.), Azienda USL-IRCCS di Reggio Emilia; Clinical and Experimental Medicine PhD Program (F.C.), University of Modena and Reggio Emilia, Modena, Italy; Grenoble Institute of Neurosciences (A.C., S.C., S.M., E.S., A.B., A.K., P.P., E.C., E.S., V.F., E.M.), University Grenoble Alpes, Inserm, U1216, Grenoble; Division of Neurosurgery (S.C., E.S.), Centre Hospitalier Universitaire (CHU), Grenoble Alpes University, France; Department of Health Sciences (S.M.), University of Milan, Italy; and Department of Neurology (P.K.), Bern University Hospital, Switzerland.
| |
Collapse
|
38
|
Bernasconi F, Blondiaux E, Potheegadoo J, Stripeikyte G, Pagonabarraga J, Bejr-Kasem H, Bassolino M, Akselrod M, Martinez-Horta S, Sampedro F, Hara M, Horvath J, Franza M, Konik S, Bereau M, Ghika JA, Burkhard PR, Van De Ville D, Faivre N, Rognini G, Krack P, Kulisevsky J, Blanke O. Robot-induced hallucinations in Parkinson's disease depend on altered sensorimotor processing in fronto-temporal network. Sci Transl Med 2021; 13:13/591/eabc8362. [PMID: 33910980 DOI: 10.1126/scitranslmed.abc8362] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/18/2020] [Accepted: 01/23/2021] [Indexed: 01/23/2023]
Abstract
Hallucinations in Parkinson's disease (PD) are disturbing and frequent non-motor symptoms and constitute a major risk factor for psychosis and dementia. We report a robotics-based approach applying conflicting sensorimotor stimulation, enabling the induction of presence hallucinations (PHs) and the characterization of a subgroup of patients with PD with enhanced sensitivity for conflicting sensorimotor stimulation and robot-induced PH. We next identify the fronto-temporal network of PH by combining MR-compatible robotics (and sensorimotor stimulation in healthy participants) and lesion network mapping (neurological patients without PD). This PH-network was selectively disrupted in an additional and independent cohort of patients with PD, predicted the presence of symptomatic PH, and associated with cognitive decline. These robotics-neuroimaging findings extend existing sensorimotor hallucination models to PD and reveal the pathological cortical sensorimotor processes of PH in PD, potentially indicating a more severe form of PD that has been associated with psychosis and cognitive decline.
Collapse
Affiliation(s)
- Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Eva Blondiaux
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Jevita Potheegadoo
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Giedre Stripeikyte
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Helena Bejr-Kasem
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Michela Bassolino
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Michel Akselrod
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,MySpace Lab, Lausanne University UNIL and University Hospital of Lausanne, CHUV, 1011 Lausanne, Switzerland
| | - Saul Martinez-Horta
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Frederic Sampedro
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Masayuki Hara
- Graduate School of Science and Engineering, Saitama University, 338-8570 Saitama, Japan
| | - Judit Horvath
- Department of Neurology, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Matteo Franza
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Stéphanie Konik
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,MySpace Lab, Lausanne University UNIL and University Hospital of Lausanne, CHUV, 1011 Lausanne, Switzerland
| | - Matthieu Bereau
- Department of Neurology, Geneva University Hospitals, 1205 Geneva, Switzerland.,Department of Neurology, Besançon University Hospital, 25056 Besançon, France
| | | | - Pierre R Burkhard
- Department of Neurology, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Dimitri Van De Ville
- Medical Image Processing Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, 1206 Geneva, Switzerland
| | - Nathan Faivre
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | - Giulio Rognini
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital and University of Bern, 3010 Bern, Switzerland
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain. .,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland. .,Department of Neurology, Geneva University Hospitals, 1205 Geneva, Switzerland
| |
Collapse
|
39
|
Weiss D, Volkmann J, Fasano A, Kühn A, Krack P, Deuschl G. Changing Gears - DBS For Dopaminergic Desensitization in Parkinson's Disease? Ann Neurol 2021; 90:699-710. [PMID: 34235776 DOI: 10.1002/ana.26164] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 12/19/2022]
Abstract
In Parkinson's disease, both motor and neuropsychiatric complications unfold as a consequence of both incremental striatal dopaminergic denervation and intensifying long-term dopaminergic treatment. Together, this leads to 'dopaminergic sensitization' steadily increasing motor and behavioral responses to dopaminergic medication that result in the detrimental sequalae of long-term dopaminergic treatment. We review the clinical presentations of 'dopaminergic sensitization', including rebound off and dyskinesia in the motor domain, and neuropsychiatric fluctuations and behavioral addictions with impulse control disorders and dopamine dysregulation syndrome in the neuropsychiatric domain. We summarize state-of-the-art deep brain stimulation, and show that STN-DBS allows dopaminergic medication to be tapered, thus supporting dopaminergic desensitization. In this framework, we develop our integrated debatable viewpoint of "changing gears", that is we suggest rethinking earlier use of subthalamic nucleus deep brain stimulation, when the first clinical signs of dopaminergic motor or neuropsychiatric complications emerge over the steadily progressive disease course. In this sense, subthalamic deep brain stimulation may help reduce longitudinal motor and neuropsychiatric symptom expression - importantly, not by neuroprotection but by supporting dopaminergic desensitization through postoperative medication reduction. Therefore, we suggest considering STN-DBS early enough before patients encounter potentially irreversible psychosocial consequences of dopaminergic complications, but importantly not before a patient shows first clinical signs of dopaminergic complications. We propose to consider neuropsychiatric dopaminergic complications as a new inclusion criterion in addition to established motor criteria, but this concept will require validation in future clinical trials. ANN NEUROL 2021.
Collapse
Affiliation(s)
- Daniel Weiss
- Centre for Neurology, Department for Neurodegenerative Diseases, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital and Julius-Maximilian-University, Würzburg, Germany
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada.,Division of Neurology, University of Toronto, Toronto, ON, Canada.,Krembil Brain Institute, Toronto, ON, Canada.,Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada
| | - Andrea Kühn
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig Holstein (UKSH), Christian-Albrechts-University Kiel, Kiel, Germany
| |
Collapse
|
40
|
Murray J, Rosenthal D, Zafar F, Lorts A, Connelly C, Krack P, Vanderpluym C, Hawkins B, Niebler R, Mehegan M, Gajarski R, Sutcliffe D, Villa C. The ABC's of Stroke Prevention: Reduction in Stroke Frequency Following a Quality Improvement Intervention by the Action Learning Network. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
41
|
Amstutz D, Michelis JP, Debove I, Maradan‐Gachet ME, Lachenmayer ML, Muellner J, Schwegler K, Krack P. Reckless Generosity, Parkinson's Disease and Dopamine: A Case Series and Literature Review. Mov Disord Clin Pract 2021; 8:469-473. [PMID: 33816681 PMCID: PMC8015883 DOI: 10.1002/mdc3.13156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/12/2021] [Accepted: 01/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Impulse control disorders (ICDs) are a frequent side effect of dopamine replacement therapy (DRT) in Parkinson's disease (PD). Reckless generosity might expand the spectrum of known ICDs. CASES Over 18 months, we encountered three PD patients exhibiting reckless generosity under DRT, leading to disastrous financial and social consequences. LITERATURE REVIEW Except for another case series describing reckless generosity in three PD patients, only one study has examined generosity in PD patients; with findings suggesting that PD patients with ICDs are less sensitive to the aversive aspects of the lack of reciprocation in social settings. Studies with healthy individuals suggest that increased availability of dopamine might reduce social discounting and promote egalitarian behavior, and thereby increase generous behavior towards strangers. Genetic studies show that polymorphisms in dopamine D4 receptors influence generous behavior. CONCLUSIONS Reckless generosity in PD patients with DRT might be underreported and should therefore be carefully be screened for by clinicians. A potential mechanism underlying this ICD-related behavior might be a sensitization of the mesolimbic and mesocortical dopaminergic system, leading to reduced social discounting and maladaptive reward-learning. Further research is needed to investigate the prevalence and underlying mechanisms of reckless generosity in PD patients.
Collapse
Affiliation(s)
- Deborah Amstutz
- Department of NeurologyUniversity Hospital Bern, University of BernFreiburgstrasse 183010 BernSwitzerland
- Graduate School for Health SciencesUniversity of BernMittelstrasse 433012 BernSwitzerland
| | - Joan Philipp Michelis
- Department of NeurologyUniversity Hospital Bern, University of BernFreiburgstrasse 183010 BernSwitzerland
| | - Ines Debove
- Department of NeurologyUniversity Hospital Bern, University of BernFreiburgstrasse 183010 BernSwitzerland
| | - Marie Elise Maradan‐Gachet
- Department of NeurologyUniversity Hospital Bern, University of BernFreiburgstrasse 183010 BernSwitzerland
- Graduate School for Health SciencesUniversity of BernMittelstrasse 433012 BernSwitzerland
| | - Martin Lenard Lachenmayer
- Department of NeurologyUniversity Hospital Bern, University of BernFreiburgstrasse 183010 BernSwitzerland
| | - Julia Muellner
- Department of NeurologyUniversity Hospital Bern, University of BernFreiburgstrasse 183010 BernSwitzerland
| | - Kyrill Schwegler
- Department of NeurologyUniversity Hospital Bern, University of BernFreiburgstrasse 183010 BernSwitzerland
| | - Paul Krack
- Department of NeurologyUniversity Hospital Bern, University of BernFreiburgstrasse 183010 BernSwitzerland
| |
Collapse
|
42
|
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: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
43
|
Cavallieri F, Fraix V, Bove F, Mulas D, Tondelli M, Castrioto A, Krack P, Meoni S, Schmitt E, Lhommée E, Bichon A, Pélissier P, Chevrier E, Kistner A, Seigneuret E, Chabardès S, Moro E. Predictors of Long-Term Outcome of Subthalamic Stimulation in Parkinson Disease. Ann Neurol 2021; 89:587-597. [PMID: 33349939 DOI: 10.1002/ana.25994] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 12/02/2020] [Accepted: 12/13/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study was undertaken to identify preoperative predictive factors of long-term motor outcome in a large cohort of consecutive Parkinson disease (PD) patients with bilateral subthalamic nucleus deep brain stimulation (STN-DBS). METHODS All consecutive PD patients who underwent bilateral STN-DBS at the Grenoble University Hospital (France) from 1993 to 2015 were evaluated before surgery, at 1 year (short-term), and in the long term after surgery. All available demographic variables, neuroimaging data, and clinical characteristics were collected. Preoperative predictors of long-term motor outcome were investigated by performing survival and univariate/multivariate Cox regression analyses. Loss of motor benefit from stimulation in the long term was defined as a reduction of less than 25% in the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III scores compared to the baseline off-medication scores. As a secondary objective, potential predictors of short-term motor outcome after STN-DBS were assessed by performing univariate and multivariate linear regression analyses. RESULTS In the long-term analyses (mean follow-up = 8.4 ± 6.26 years, median = 10 years, range = 1-17 years), 138 patients were included. Preoperative higher frontal score and off-medication MDS-UPDRS part III scores predicted a better long-term motor response to stimulation, whereas the presence of vascular changes on neuroimaging predicted a worse motor outcome. In 357 patients with available 1-year follow-up, preoperative levodopa response, tremor dominant phenotype, baseline frontal score, and off-medication MDS-UPDRS part III scores predicted the short-term motor outcome. INTERPRETATION Frontal lobe dysfunction, disease severity in the off-medication condition, and the presence of vascular changes on neuroimaging represent the main preoperative clinical predictors of long-term motor STN-DBS effects. ANN NEUROL 2021;89:587-597.
Collapse
Affiliation(s)
- Francesco Cavallieri
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France.,Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Valérie Fraix
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France.,Grenoble Institute of Neurosciences, UGA INSERM U1216, Grenoble, France
| | - Francesco Bove
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France.,Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Delia Mulas
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France.,Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy.,Neurology Unit, Mater Olbia Hospital, Olbia, Italy
| | - Manuela Tondelli
- Neurology Unit, University Hospital Policlinico, Department of Biomedical, Metabolic, and Neural Science, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Castrioto
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France.,Grenoble Institute of Neurosciences, UGA INSERM U1216, Grenoble, France
| | - Paul Krack
- Department of Neurology, Center for Parkinson's Disease and Movement Disorders, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sara Meoni
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France.,Grenoble Institute of Neurosciences, UGA INSERM U1216, Grenoble, France
| | - Emmanuelle Schmitt
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France
| | - Eugénie Lhommée
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France
| | - Amélie Bichon
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France
| | - Pierre Pélissier
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France
| | - Eric Chevrier
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France
| | - Andrea Kistner
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France.,Grenoble Institute of Neurosciences, UGA INSERM U1216, Grenoble, France
| | - Eric Seigneuret
- Grenoble Institute of Neurosciences, UGA INSERM U1216, Grenoble, France.,Division of Neurosurgery, Grenoble Alpes University Hospital Center, Grenoble, France
| | - Stephan Chabardès
- Grenoble Institute of Neurosciences, UGA INSERM U1216, Grenoble, France.,Division of Neurosurgery, Grenoble Alpes University Hospital Center, Grenoble, France
| | - Elena Moro
- Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France.,Grenoble Institute of Neurosciences, UGA INSERM U1216, Grenoble, France
| |
Collapse
|
44
|
Cavalloni F, Debove I, Lachenmayer ML, Krack P, Pollo C, Schuepbach WMM, Bassetti CLA, Bargiotas P. A case series and systematic review of rapid eye movement sleep behavior disorder outcome after deep brain stimulation in Parkinson's disease. Sleep Med 2021; 77:170-176. [PMID: 33412362 DOI: 10.1016/j.sleep.2020.11.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/09/2020] [Accepted: 11/23/2020] [Indexed: 02/07/2023]
Abstract
REM-sleep behavior disorder (RBD) is a parasomnia and a common sleep disorder in Parkinson's disease (PD). While deep brain stimulation (DBS) is an established treatment for advanced PD with beneficial effects on cardinal PD motor symptoms, the data on the impact of DBS on RBD are limited and often controversial. We reviewed published articles that reported on RBD in the context of DBS surgery via systematic PubMed search. We identified 75 studies and included 12 studies, involving a total of 320 subjects, in our review. Results in respect to EMG activity outcome after subthalamic stimulation are inconsistent. We found no study that reported on RBD outcome after pallidal DBS and no DBS study quantified complex behavior during REM sleep. We also added data on RBD outcome after subthalamic (N = 4 patients) or pallidal (N = 3 patients) DBS from patients with PD with RBD, obtained as part of a prospective DBS study in our centre. Our case series showed an increase of complex behavior during REM (CB-REM) after surgery, independent of DBS target. Conversely, we found a trend towards increasing REM sleep without atonia (RSWA) in subthalamic-stimulated patients and a trend towards decreased RSWA in pallidal stimulated patients. We conclude that CB-REM and RSWA might represent two distinct elements in RBD and should be assessed separately, especially in studies that report on RBD outcome after treatment interventions. Further, larger, prospective, controlled studies in different DBS targets, reporting separately on the different RBD modalities, are needed.
Collapse
Affiliation(s)
- Fabian Cavalloni
- Department of Neurology, University Hospital Bern (Inselspital), 3010, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, University Hospital Bern (Inselspital), 3010, Bern, Switzerland
| | - M Lenard Lachenmayer
- Department of Neurology, University Hospital Bern (Inselspital), 3010, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, University Hospital Bern (Inselspital), 3010, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, University Hospital Bern (Inselspital), 3010, Bern, Switzerland
| | - W M Michael Schuepbach
- Department of Neurology, University Hospital Bern (Inselspital), 3010, Bern, Switzerland
| | - Claudio L A Bassetti
- Department of Neurology, University Hospital Bern (Inselspital), 3010, Bern, Switzerland
| | - Panagiotis Bargiotas
- Department of Neurology, University Hospital Bern (Inselspital), 3010, Bern, Switzerland; Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus.
| |
Collapse
|
45
|
Chabardes S, Krack P, Piallat B, Bougerol T, Seigneuret E, Yelnik J, Fernandez Vidal S, David O, Mallet L, Benabid AL, Polosan M. Deep brain stimulation of the subthalamic nucleus in obsessive-compulsives disorders: long-term follow-up of an open, prospective, observational cohort. J Neurol Neurosurg Psychiatry 2020; 91:1349-1356. [PMID: 33033168 PMCID: PMC7677463 DOI: 10.1136/jnnp-2020-323421] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/01/2020] [Accepted: 08/31/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a major cause of disability in western country and responsible for severe impairment of quality of life. About 10% of patients present with severe OCD symptoms and require innovative treatment such as deep brain stimulation (DBS). Among possible targets, the non-motor subthalamic nucleus (STN) is a key node of the basal ganglia circuitry, strongly connected to limbic cortical areas known to be involved in OCD. METHOD We analysed, in a prospective, observational, monocentric, open label cohort, the effect of chronic non-motor STN-DBS in 19 patients with treatment-resistant OCD consecutively operated in a single centre. Severity of OCD was evaluated using the Yale and Brown Obsessive-Compulsive Scale (YBOCS). YBOCS scores at 6, 12 and 24 months postoperatively were compared with baseline. Responders were defined by >35% improvement of YBOCS scores. Global Assessment Functioning (GAF) scale was used to evaluate the impact of improvement. RESULTS At a 24-month follow-up, the mean YBOCS score improved by 53.4% from 33.3±3.5 to 15.8±9.1 (95% CI 11.2-20.4; p<0.0001). Fourteen out of 19 patients were considered as responders, 5 out of 19 being improved over 75% and 10 out of 19 over 50%. GAF scale improved by 92% from 34.1±3.9 to 66.4±18.8 (95% CI 56.7-76.1; p=0.0003). The most frequent adverse events consisted of transient DBS-induced hypomania and anxiety. CONCLUSION Chronic DBS of the non-motor STN is an effective and relatively safe procedure to treat severe OCD resistant to conventional management.
Collapse
Affiliation(s)
- Stephan Chabardes
- CLINATEC, CEA Clinatec-Minatec, Grenoble, France .,Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.,Grenoble Institut neurosciences, University Grenoble Alpes-INSERM U1216, 38000 Grenoble, France
| | - Paul Krack
- Division of Neurology, Department of Neurology, Bern University Hospital, Bern, Switzerland, Bern, Switzerland.,Department of Neurology, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Brigitte Piallat
- Grenoble Institut neurosciences, University Grenoble Alpes-INSERM U1216, 38000 Grenoble, France
| | - Thierry Bougerol
- Department of Psychiatry, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Eric Seigneuret
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Jerome Yelnik
- Institut du Cerveau, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | - Sara Fernandez Vidal
- Institut du Cerveau, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | - Olivier David
- Grenoble Institut neurosciences, University Grenoble Alpes-INSERM U1216, 38000 Grenoble, France
| | - Luc Mallet
- Institut du Cerveau, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France.,Département Médical-Universitaire de Psychiatrie et d'Addictologie, Univ Paris-Est Créteil, DMU IMPACT, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Créteil, France.,Department of Mental Health and Psychiatry, Global Health Institute, University of Geneva, Geneva, Switzerland
| | | | - Mircea Polosan
- Grenoble Institut neurosciences, University Grenoble Alpes-INSERM U1216, 38000 Grenoble, France.,Department of Psychiatry, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| |
Collapse
|
46
|
Fleury V, Catalano Chiuvé S, Forjaz MJ, Di Marco M, Messe M, Debove I, Angulo J, Hariz GM, Burkhard PR, Martinez-Martin P, Rodriguez-Blazquez C, Krack P. Embarrassment and Shame in People With Parkinson's Disease: A New Tool for Self-Assessment. Front Neurol 2020; 11:779. [PMID: 32849230 PMCID: PMC7411180 DOI: 10.3389/fneur.2020.00779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
Shame and embarrassment related to Parkinson's disease (PD) are rarely addressed in clinical practice nor studied in neuroscience research, partly because no specific tool exists to detect them in PD. Objective: To develop a self-applied assessment tool of shame and embarrassment specifically related to PD or its treatment, to promptly identify the presence and severity of these two emotions in PD. Methods: Identification and selection of relevant items were obtained from the collection of PD patients' opinions during support groups and interviews. Several further items were added following a literature review. Subsequently, a two-phase pilot study was performed for identification of ambiguous items and omissions, and to obtain preliminary data on acceptability, reliability, validity and relevance of the new scale (SPARK). Results: A total of 105 PD patients were enrolled in the study. Embarrassment was reported in 85% of patients, while shame was present in 26%. Fifteen percent of patients did not describe any shame or embarrassment. On average, the intensity of these two emotions was low with a marked floor effect in SPARK items and subscales. However, SPARK total score inter-individual variability was important (range 1-84 out of 99). Acceptability and quality of data were satisfactory with no floor or ceiling effects (2.9% each) or missing data. Internal consistency (Cronbach's alpha) was 0.94 for total score and 0.73-0.87 for subscales. The scale correlated ≥0.60 with instruments measuring related constructs. Content validity was satisfactory. SPARK total score strongly correlated with impaired health-related quality of life (rS = 0.81), the propensity to feel embarrassed or ashamed (rS = 0.68 and 0.66, respectively), and anxiety (rS = 0.72) and depression (rS = 0.63) levels. Moderate to high correlations were observed between SPARK total score and apathy (rS = 0.46) and a more pronounced personality trait directed toward harm avoidance (rS = 0.46). No significant differences in SPARK scores were found by sex, education level, PD duration, Hoehn and Yahr stages or PD phenotype. Conclusion: Preliminary analysis of psychometric properties suggests that SPARK could be an acceptable and reliable instrument for assessing shame and embarrassment in PD. SPARK could help healthcare professionals to identify and characterize PD-induced shame and embarrassment.
Collapse
Affiliation(s)
- Vanessa Fleury
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | | | - Maria João Forjaz
- National Centre of Epidemiology, Carlos III Institute of Health, REDISSEC, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | | | - Maria Messe
- Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Ines Debove
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Julio Angulo
- Morningview Place, Lake Oswego, OR, United States.,Member, Persons With Parkinson's Advisory Council, Parkinson Foundation, Miami, FL, United States.,Member, Program Design Committee 2019 World Parkinson's Congress, World Parkinson's Coalition, New York, NY, United States
| | - Gun-Marie Hariz
- Department of Clinical Science, Neuroscience, Umeå University, Umeå, Sweden
| | - Pierre R Burkhard
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology, Carlos III Institute of Health, REDISSEC, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| |
Collapse
|
47
|
Stoker V, Krack P, Tonder L, Barnett G, Durand-Zaleski I, Schnitzler A, Houeto JL, Timmermann L, Rau J, Schade-Brittinger C, Vidailhet M, Deuschl G. Deep Brain Stimulation Impact on Social and Occupational Functioning in Parkinson's Disease with Early Motor Complications. Mov Disord Clin Pract 2020; 7:672-680. [PMID: 32775513 PMCID: PMC7396868 DOI: 10.1002/mdc3.13015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/15/2020] [Accepted: 06/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background Deep brain stimulation (DBS) improves motor symptoms and quality of life in patients with Parkinson's disease (PD) and early motor complications, suggesting that DBS could be prescribed to the working‐age PD population. Objectives To investigate the effect of DBS compared with best medical therapy (BMT) on social, psychosocial, and occupational functioning in patients with PD ≤60 years of age with early motor complications, its correlates, and possible underlying rationale. Methods Methods included analyses of the Social and Occupational Functioning Assessment Scale, Scales for Outcomes for Parkinson's–Psychosocial, Professional Fitness, Starkstein Apathy Scale, and Schwab and England Activities of Daily Living Scale from the EARLYSTIM study. Results Compared with BMT, DBS resulted in significantly greater improvements from baseline through 24 months in social,occupational, and psychosocial functioning. Yet, work status in the 2 groups did not differ at baseline and 24 months. Physicians reported a significantly higher percentage of patients in the BMT group unable to work at 24 months relative to baseline compared with the DBS group. Apathy was significantly worse in patients for whom physicians overrated ability to work when compared with patients’ own ratings than in the group of patients who physicians' ability to work ratings were comparable to, or worse than, patients' self‐ratings of ability to work. Conclusions For patients aged ≤60 years with PD and early motor complications, DBS provided significant improvements in social, occupational, and psychosocial function, but not in the actual work engagement compared with BMT at 2 years. Apathy may impact ability to work.
Collapse
Affiliation(s)
| | - Paul Krack
- Department of Neurology University Hospital Bern and University of Bern Bern Switzerland
| | | | | | | | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, and Department of Neurology Heinrich-Heine University Duesseldorf Duesseldorf Germany
| | - Jean-Luc Houeto
- Department of Neurology, Clinical Investigational Centers-Institut National de la Sante et de la Recherche Medicale 1402, Centre Hospitalier Universitaire of Poitiers University of Poitiers Poitiers France
| | | | - Joern Rau
- The Coordinating Center for Clinical Trials Philipps University Marburg Germany
| | | | - Marie Vidailhet
- Sorbonne Université, Insitut du Cerveau et de la Moelle Epinere UMR1127, Insitut National de la Sante et de la Recherche Medicale &1127, Centre National de la Recherche Scientifique 7225, Department of Neurology Salpêtriere University Hospital Assistance Publique - Hôpitaux de Paris Paris France
| | - Günther Deuschl
- Department of Neurology, Universitätsklinikum Schleswig-Holstein Kiel Campus Christian-Albrechts-University Kiel Germany
| | | |
Collapse
|
48
|
Amstutz D, Paschen S, Lachenmayer ML, Maradan-Gachet ME, Deuschl G, Krack P, Debove I. Management of Impulse Control Disorders with Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease. CNS Neurol Disord Drug Targets 2020; 19:611-617. [PMID: 32691720 DOI: 10.2174/1871527319666200720105553] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/29/2020] [Accepted: 06/08/2020] [Indexed: 11/22/2022]
Abstract
Impulse Control Disorders (ICDs) and related disorders are common side effects of dopaminergic treatment in Parkinson's Disease (PD) and are associated with negative effects on mental and physical health, quality of life and interpersonal relationships. Current management options are limited, as a reduction of dopaminergic medication often leads to worsening of motor symptoms or dopamine agonist withdrawal syndrome. The aim of this review was to investigate if ICDs improve, worsen, or remain stable after Subthalamic Nucleus Deep Brain Stimulation (STN-DBS). We reviewed retrospective, prospective and randomized-controlled studies published between 2000 and 2019 examining the effect of STN-DBS on one or more ICDs. The number of participants, time of follow-up, methods used to measure ICDs, type of ICDs, the incidence of ICDs before STN-DBS, the incidence of improvement (remission or reduction) of ICDs after STN-DBS, the incidence of de novo ICDs after STN-DBS, stimulation parameters, lead position, change in motor score and change in medication are reported for each study. Available studies suggest that ICDs improve after STN-DBS in most patients and that persisting new-onset ICDs induced by STN-DBS are rare. However, more randomized-controlled studies are needed to confirm the findings and to further investigate the underlying mechanisms.
Collapse
Affiliation(s)
- Deborah Amstutz
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Steffen Paschen
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Martin Lenard Lachenmayer
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | | | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| |
Collapse
|
49
|
Khawaldeh S, Tinkhauser G, Shah SA, Peterman K, Debove I, Nguyen TAK, Nowacki A, Lachenmayer ML, Schuepbach M, Pollo C, Krack P, Woolrich M, Brown P. Subthalamic nucleus activity dynamics and limb movement prediction in Parkinson's disease. Brain 2020; 143:582-596. [PMID: 32040563 PMCID: PMC7009471 DOI: 10.1093/brain/awz417] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/21/2019] [Accepted: 11/19/2019] [Indexed: 02/01/2023] Open
Abstract
Whilst exaggerated bursts of beta frequency band oscillatory synchronization in the subthalamic nucleus have been associated with motor impairment in Parkinson's disease, a plausible mechanism linking the two phenomena has been lacking. Here we test the hypothesis that increased synchronization denoted by beta bursting might compromise information coding capacity in basal ganglia networks. To this end we recorded local field potential activity in the subthalamic nucleus of 18 patients with Parkinson's disease as they executed cued upper and lower limb movements. We used the accuracy of local field potential-based classification of the limb to be moved on each trial as an index of the information held by the system with respect to intended action. Machine learning using the naïve Bayes conditional probability model was used for classification. Local field potential dynamics allowed accurate prediction of intended movements well ahead of their execution, with an area under the receiver operator characteristic curve of 0.80 ± 0.04 before imperative cues when the demanded action was known ahead of time. The presence of bursts of local field potential activity in the alpha, and even more so, in the beta frequency band significantly compromised the prediction of the limb to be moved. We conclude that low frequency bursts, particularly those in the beta band, restrict the capacity of the basal ganglia system to encode physiologically relevant information about intended actions. The current findings are also important as they suggest that local subthalamic activity may potentially be decoded to enable effector selection, in addition to force control in restorative brain-machine interface applications.
Collapse
Affiliation(s)
- Saed Khawaldeh
- MRC Brain Network Dynamics Unit, University of Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Gerd Tinkhauser
- MRC Brain Network Dynamics Unit, University of Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Syed Ahmar Shah
- MRC Brain Network Dynamics Unit, University of Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Usher Institute of Population Health Sciences and Informatics, Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Katrin Peterman
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Ines Debove
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - T A Khoa Nguyen
- Department of Neurosurgery, Bern University Hospital and University of Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Bern University Hospital and University of Bern, Switzerland
| | - M Lenard Lachenmayer
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Michael Schuepbach
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, Bern University Hospital and University of Bern, Switzerland
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Mark Woolrich
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Peter Brown
- MRC Brain Network Dynamics Unit, University of Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| |
Collapse
|
50
|
Béreau M, Kibleur A, Bouthour W, Tomkova Chaoui E, Maling N, Nguyen TAK, Momjian S, Vargas Gomez MI, Zacharia A, Bally JF, Fleury V, Tatu L, Burkhard PR, Krack P. Modeling of Electric Fields in Individual Imaging Atlas for Capsular Threshold Prediction of Deep Brain Stimulation in Parkinson's Disease: A Pilot Study. Front Neurol 2020; 11:532. [PMID: 32714264 PMCID: PMC7343907 DOI: 10.3389/fneur.2020.00532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 05/13/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Modeling of deep brain stimulation electric fields and anatomy-based software might improve post-operative management of patients with Parkinson's disease (PD) who have benefitted from subthalamic nucleus deep brain stimulation (STN-DBS). Objective: We compared clinical and software-guided determination of the thresholds for current diffusion to the pyramidal tract, the most frequent limiting side effect in post-operative management of STN-DBS PD patients. Methods: We assessed monopolar reviews in 16 consecutive STN-DBS PD patients and retrospectively compared clinical capsular thresholds, which had been assessed according to standard clinical practice, to those predicted by volume of tissue activated (VTA) model software. All the modeling steps were performed blinded from patients' clinical evaluations. Results: At the group level, we found a significant correlation (p = 0.0001) when performing statistical analysis on the z-scored capsular thresholds, but with a low regression coefficient (r = 0.2445). When considering intra-patient analysis, we found significant correlations (p < 0.05) between capsular threshold as modeled with the software and capsular threshold as determined clinically in five patients (31.2%). Conclusions: In this pilot study, the VTA model software was of limited assistance in identifying capsular thresholds for the whole cohort due to a large inter-patient variability. Clinical testing remains the gold standard in selecting stimulation parameters for STN-DBS in PD.
Collapse
Affiliation(s)
- Matthieu Béreau
- Department of Neurology, Besançon University Hospital, Besançon, France.,Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Astrid Kibleur
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Walid Bouthour
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | | | | | - T A Khoa Nguyen
- Department of Neurology, Bern University Hospital, Bern, Switzerland
| | - Shahan Momjian
- Department of Neurosurgery, Geneva University Hospital, Geneva, Switzerland
| | | | - André Zacharia
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Julien F Bally
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Vanessa Fleury
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Laurent Tatu
- Department of Neurology, Besançon University Hospital, Besançon, France
| | - Pierre R Burkhard
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Paul Krack
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland.,Department of Neurology, Bern University Hospital, Bern, Switzerland
| |
Collapse
|