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  • 1
    Online Resource
    Online Resource
    Postoperative apathy can neutralise benefits in quality of life after subthalamic stimulation for Parkinson's disease
    BMJ ; 2016
    In:  Journal of Neurology, Neurosurgery & Psychiatry Vol. 87, No. 3 ( 2016-03), p. 311-318
    Details
    In: Journal of Neurology, Neurosurgery & Psychiatry, BMJ, Vol. 87, No. 3 ( 2016-03), p. 311-318
    Type of Medium: Online Resource
    ISSN: 0022-3050 , 1468-330X
    URL: Article
    DOI: 10.1136/jnnp-2014-310189
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2016
    detail.hit.zdb_id: 1480429-3
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  • 2
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    Long‐term independence and quality of life after subthalamic stimulation in Parkinson disease
    Wiley ; 2022
    In:  European Journal of Neurology Vol. 29, No. 9 ( 2022-09), p. 2645-2653
    Details
    In: European Journal of Neurology, Wiley, Vol. 29, No. 9 ( 2022-09), p. 2645-2653
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 1351-5101 , 1468-1331
    URL: Issue
    URL: Article
    DOI: 10.1111/ene.v29.9
    DOI: 10.1111/ene.15436
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2020241-6
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  • 3
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    Do neuropsychiatric fluctuations temporally match motor fluctuations in Parkinson’s disease?
    Springer Science and Business Media LLC ; 2022
    In:  Neurological Sciences Vol. 43, No. 6 ( 2022-06), p. 3641-3647
    Details
    In: Neurological Sciences, Springer Science and Business Media LLC, Vol. 43, No. 6 ( 2022-06), p. 3641-3647
    Type of Medium: Online Resource
    ISSN: 1590-1874 , 1590-3478
    URL: Article
    DOI: 10.1007/s10072-021-05833-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1481772-X
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  • 4
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    The Neuropsychiatric Fluctuations Scale for Parkinson's Disease: A Pilot Study
    Wiley ; 2018
    In:  Movement Disorders Clinical Practice Vol. 5, No. 3 ( 2018-05), p. 265-272
    Details
    In: Movement Disorders Clinical Practice, Wiley, Vol. 5, No. 3 ( 2018-05), p. 265-272
    Abstract: Non‐motor fluctuations represent a main source of disability in Parkinson's disease (PD). Among them, neuropsychiatric fluctuations are the most frequent and are often under‐recognized by patients and physicians, partly because specific tools for assessment of neuropsychiatric fluctuations are lacking. Objective To develop a scale for detecting and evaluating the presence and the severity of neuropsychological symptoms during the ON and OFF phases of non‐motor fluctuations. Methods Neuropsychiatric symptoms reported by PD patients in the OFF‐ and the ON‐medication conditions were collected using different neuropsychiatric scales (BDI‐II, BAI, Young, VAS, etc.). Subsequently, tree phases of a pilot study was performed for cognitive pretesting, identification of ambiguous or redundant items (item reduction), and to obtain preliminary data of acceptability of the new scale. In all the three phases, the scale was applied in both the OFF and ON condition during a levodopa challenge. Results Twenty items were selected for the final version of the neuropsychiatric fluctuation scale (NFS): ten items measured the ON neuropsychological symptoms and ten items the OFF neuropsychological manifestations. Each item rated from 0‐3, providing respective subscores from 0 to 30. Conclusions Once validated, our NFS can be used to identify and quantify neuropsychiatric fluctuations during motor fluctuations. The main novelty is that it could be used in acute settings. As such, the NFS can assess the neuropsychiatric state of the patient at the time of examination. The next step will be to validate the NFS to be used in current practice.
    Type of Medium: Online Resource
    ISSN: 2330-1619 , 2330-1619
    URL: Issue
    URL: Article
    DOI: 10.1002/mdc3.2018.5.issue-3
    DOI: 10.1002/mdc3.12607
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2772809-2
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  • 5
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    Axial impairment and falls in Parkinson’s disease: 15 years of subthalamic deep brain stimulation
    Springer Science and Business Media LLC ; 2022
    In:  npj Parkinson's Disease Vol. 8, No. 1 ( 2022-09-24)
    Details
    In: npj Parkinson's Disease, Springer Science and Business Media LLC, Vol. 8, No. 1 ( 2022-09-24)
    Abstract: In this retrospective study, we longitudinally analyzed axial impairment and falls in people with Parkinson’s disease (PD) and subthalamic nucleus deep brain stimulation (STN-DBS). Axial scores and falling frequency were examined at baseline, and 1, 10, and 15 years after surgery. Preoperative demographic and clinical data, including PD duration and severity, phenotype, motor and cognitive scales, medications, and vascular changes on neuroimaging were examined as possible risk factors through Kaplan–Meier and Cox regression analyses. Of 302 individuals examined before and at 1 year after surgery, 102 and 57 were available also at 10 and 15 years of follow-up, respectively. Axial scores were similar at baseline and at 1 year but worsened at 10 and 15 years. The prevalence rate of frequent fallers progressively increased from baseline to 15 years. Preoperative axial scores, frontal dysfunction and age at PD onset were risk factors for axial impairment progression after surgery. Axial scores, akinetic/rigid phenotype, age at disease onset and disease duration at surgery predicted frequent falls. Overall, axial signs progressively worsened over the long-term period following STN-DBS, likely related to the progression of PD, especially in a subgroup of subjects with specific risk factors.
    Type of Medium: Online Resource
    ISSN: 2373-8057
    URL: Article
    DOI: 10.1038/s41531-022-00383-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2819218-7
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  • 6
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    Fluctuations in Parkinson’s disease and personalized medicine: bridging the gap with the neuropsychiatric fluctuation scale
    Frontiers Media SA ; 2023
    In:  Frontiers in Neurology Vol. 14 ( 2023-8-17)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 14 ( 2023-8-17)
    Abstract: Neuropsychiatric fluctuations (NpsyF) are frequent and disabling in people with Parkinson’s disease (PD). In OFF-medication, NpsyF entail minus neuropsychiatric symptoms (NPS) like anxiety, apathy, sadness, and fatigue. In ON-medication, NpsyF consist in plus NPS, such as high mood, hypomania, and hyperactivity. Accurate identification of these NpsyF is essential to optimize the overall PD management. Due to lack of punctual scales, the neuropsychiatric fluctuation scale (NFS) has been recently designed to assess NpsyF in real time. The NFS comprises 20 items with two subscores for plus and minus NPS, and a total score. Objective To evaluate the psychometric properties of the NFS in PD. Methods PD patients with motor fluctuations and healthy controls (HC) were assessed. In PD patients, the NFS was administrated in both the ON-and OFF-medication conditions, together with the movement disorders society-unified Parkinson disease rating scale parts I–IV. Depression (Beck depression scale II), apathy (Starkstein apathy scale) and non-motor fluctuations items of the Ardouin scale of behaviour in PD (ASBPD OFF and ON items) were also assessed. NFS internal structure was evaluated with principal component analysis consistency (PCA) in both medication conditions in PD patients and before emotional induction in HC. NFS internal consistency was assessed using Cronbach’s alpha coefficient. NFS convergent and divergent validity was measured through correlations with BDI-II, Starktein, and ASBPD OFF and ON non motor items. Specificity was assessed comparing NFS global score between the HC and PD populations. Sensitivity was evaluated with t-student test comparing the ON-and the OFF-medication conditions for NFS global score and for minus and plus subscores. Results In total, 101 consecutive PD patients and 181 HC were included. In PD patients and HC, PCA highlighted one component that explained 32–35 and 42% of the variance, respectively. Internal consistency was good for both the NFS -plus (alpha =0.88) and NFS -minus items (alpha =0.8). The NFS showed a good specifity for PD ( p  & lt; 0.0001) and a good sensitivity to the medication condition ( p  & lt; 0.0001). Conclusion The satisfactory properties of the NFS support its use to assess acute neuropsychiatric fluctuations in PD patients, adding to available tools.
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    DOI: 10.3389/fneur.2023.1242484
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2564214-5
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  • 7
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    Psychostimulant effect of dopaminergic treatment and addictions in Parkinson's disease
    Wiley ; 2017
    In:  Movement Disorders Vol. 32, No. 11 ( 2017-11), p. 1566-1573
    Details
    In: Movement Disorders, Wiley, Vol. 32, No. 11 ( 2017-11), p. 1566-1573
    Abstract: Background : Dopamine replacement therapy in PD has been associated with both behavioral addictions and dopamine addiction. Objectives : To investigate potential association between l ‐dopa induced neuropsychiatric fluctuations and addictions in PD. Methods : A cohort of 102 patients with PD suffering from motor complications of l ‐dopa treatment was prospectively analyzed. We evaluated dopamine addiction, behavioral addictions, and neuropsychiatric fluctuations using the Ardouin scale of behavior in PD. Results : Patients with (n = 51) or without (n = 51) neuropsychiatric fluctuations did not differ in age, disease duration, medication, or UPDRS III motor score during on and off drug condition. Patients with neuropsychiatric fluctuations had a higher H & Y stage in off ‐drug condition. A multivariate model showed that dopamine addiction (odds ratio: 8.9; P  = 0.02) and behavioral addictions (odds ratio: 3.76; P  = 0.033) were more frequent in the presence of neuropsychiatric fluctuations. Behavioral addictions and dopamine addiction were more frequent in the presence than in the absence of on ‐drug euphoria (46% vs. 13.9%; P   〈  0.001 and 27% vs 6.2 %; P  = 0.003), while conversely, no association emerged between dopamine or behavioral addictions and presence of off ‐drug dysphoria. Patients with neuropsychiatric fluctuations had a poorer quality of life and a more frequent history of anxiety disorder. Conclusions : The psychostimulant effects of dopamine treatment during on ‐drug euphoria, rather than avoidance of off ‐drug dysphoria, appear to drive both behavioral addictions and abuse of medication. © 2017 International Parkinson and Movement Disorder Society
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    URL: Article
    DOI: 10.1002/mds.v32.11
    DOI: 10.1002/mds.27101
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2041249-6
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  • 8
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    Early Parkinson’s Disease Phenotypes Tailored by Personality, Behavior, and Motor Symptoms
    IOS Press ; 2022
    In:  Journal of Parkinson's Disease Vol. 12, No. 5 ( 2022-07-08), p. 1665-1676
    Details
    In: Journal of Parkinson's Disease, IOS Press, Vol. 12, No. 5 ( 2022-07-08), p. 1665-1676
    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.
    Type of Medium: Online Resource
    ISSN: 1877-7171 , 1877-718X
    URL: Article
    DOI: 10.3233/JPD-213070
    Language: Unknown
    Publisher: IOS Press
    Publication Date: 2022
    detail.hit.zdb_id: 2599550-9
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  • 9
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    Personality, dopamine, and Parkinson's disease: Insights from subthalamic stimulation
    Wiley ; 2017
    In:  Movement Disorders Vol. 32, No. 8 ( 2017-08), p. 1191-1200
    Details
    In: Movement Disorders, Wiley, Vol. 32, No. 8 ( 2017-08), p. 1191-1200
    Abstract: Background : Subthalamic stimulation improves the motor and neuropsychiatric symptoms of Parkinson's disease. However, the impact of this treatment on impulse control and personality is the subject of heavy debate. The objective of this study was to investigate personality changes after subthalamic stimulation. Methods : Using Cloninger's biosocial model, we assessed personality in 73 Parkinson's disease patients before and 12 months after subthalamic stimulation accompanied by a drastic reduction in dopaminergic medication. Changes in psychobehavioral symptoms were measured using a battery of validated clinical scales (apathy, depression, anxiety, hyperemotionality, mania, psychosis, punding, and impulse control behaviors). Results : One year after surgery, the harm avoidance personality domain total score increased compared with the baseline (+2.8; 34 patients; P   〈  0.001), as did 3 of its 4 subdomains: anticipatory worry (+0.7; 10 patients; P  = 0.005), shyness (+0.6; 7 patients; P  = 0.03), and fatigability (+1.1; 10 patients; P  = 0.0014). Evolution of the shyness personality trait correlated with the decrease in dopaminergic medication. Total scores in the other personality domains remained unchanged, except for extravagance, a subdomain of novelty seeking, and persistence, a subdomain of reward dependence, which both decreased following surgery (‐0.3; 7 patients; and ‐0.6; 9 patients; P  = 0.03 and P  = 0.0019, respectively). Although apathy increased, other psychobehavioral symptoms, including impulse control behaviors and neuropsychiatric nonmotor fluctuations, improved. Depression and anhedonia remained stable. Scores in hypodopaminergia and neuropsychiatric nonmotor OFF correlated with harm avoidance. Scores in hyperdopaminergia and neuropsychiatric nonmotor ON correlated with novelty seeking. Conclusions : When subthalamic stimulation is applied in Parkinson's disease, significant changes in personality traits are observed, which may be related to postoperative tapering of dopaminergic treatment. © 2017 International Parkinson and Movement Disorder Society
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    URL: Article
    DOI: 10.1002/mds.v32.8
    DOI: 10.1002/mds.27065
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2041249-6
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  • 10
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    Limbic Serotonergic Plasticity Contributes to the Compensation of Apathy in Early Parkinson's Disease
    Wiley ; 2022
    In:  Movement Disorders Vol. 37, No. 6 ( 2022-06), p. 1211-1221
    Details
    In: Movement Disorders, Wiley, Vol. 37, No. 6 ( 2022-06), p. 1211-1221
    Abstract: 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
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    URL: Article
    DOI: 10.1002/mds.v37.6
    DOI: 10.1002/mds.28971
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2041249-6
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