OBJECTIVE: To identify a presurgical metabolic pattern using (18)FDG-PET which could predict postoperative apathy after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson Disease (PD).BACKGROUND: STN-DBS in PD has been associated with postoperative apathy. There is an ongoing debate whether STN-DBS or drug modifications are causal in the development of postoperative apathy.DESIGN/METHODS: Nineteen PD patients scheduled for STN DBS surgery, not clinically apathetic (Lille Apathy Rating Scale LARS<-16) nor depressed (Montgomery and Asberg Depression Rating Scale MADRS <21) underwent a (18) FDG-PET scan before STN-DBS and were assessed with LARS and MADRS before and one year after surgery. Whole-brain voxel-based (18)FDG-PET intergroup comparison was evaluated between patients with and without postoperative apathy, using SPM8 (p < 0.005, uncorrected).RESULTS: Five patients became apathetic after surgery (LARS蠅-16). Positive correlation were observed between the postoperative LARS and presurgical cerebral metabolism in posterior fossa (p=0.030), temporal area (p=0.038) and cingulum (p=0.057).CONCLUSIONS: These preliminary results confirm that frontal, temporal and posterior area are implicated in apathy (Robert et al, 2012) but suggest a metabolic predisposition to post STN-DBS apathy. This may indicate that STN-DBS and perioperative drug modifications are not the exclusive causes of postoperative apathy.
Disclosure: Dr. Gesquiere-Dando has nothing to disclose. Dr. Guedj has nothing to disclose. Dr. Witjas has received personal compensation for activities with GlaxoSmithKline Inc., Medtronic Inc., Boehringer Ingelheim Pharmaceuticals Inc., and UCB Pharma. Dr. Fluchere has nothing to disclose. Dr. Delfini has nothing to disclose. Dr. Mundler has nothing to disclose. Dr. Azulay has received personal compensation for activities with GlaxoSmithKlyne Inc., Boehringer Ingelheim Pharmaceuticals, Inc., UCB Pharma, Novartis, Teva Neuroscience, and Lundbeck Research USA, Inc. Dr. Eusebio has nothing to disclose.
Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/P2.003?rss=1
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