Depression leading to attempted suicide after bilateral subthalamic nucleus stimulation for Parkinson's disease

Doshi, Paresh K; Chhaya, Niraj; Bhatt, Mohit

doi:10.1002/mds.10198

Cited by 162 publications

(104 citation statements)

References 8 publications

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“…However, transient euphoria and manic psychosis or anhedonia and depression were also reported to compromise the motor benefit of STN stimulation in the first weeks after device implantation Doshi et al, 2002;Krack et al, 2001Krack et al, , 2002Volkmann et al, 2001). In our small PD study sample, severe neuropsychiatric side effects were observed in three out of eight patients within the first 6 weeks after surgery.…”

Section: Figmentioning

confidence: 64%

Subthalamic Nucleus Stimulation Restores Glucose Metabolism in Associative and Limbic Cortices and in Cerebellum: Evidence from a FDG-PET Study in Advanced Parkinson's Disease

Hilker¹,

Voges

Weisenbach

et al. 2004

J Cereb Blood Flow Metab

192

155

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Summary: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a highly effective surgical treatment in patients with advanced Parkinson's disease (PD). Because the STN has been shown to represent an important relay station not only in motor basal ganglia circuits, the modification of brain areas also involved in nonmotor functioning can be expected by this intervention. To determine the impact of STN-DBS upon the regional cerebral metabolic rate of glucose (rCMRGlc), we performed positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) in eight patients with advanced PD before surgery as well as in the DBS on-and off-conditions 4 months after electrode implantation and in ten age-matched healthy controls. Before surgery, PD patients showed widespread bilateral reductions of cortical rCMRGlc versus controls but a hypermetabolic state in the left rostral cerebellum. In the STN-DBS on-condition, clusters of significantly increased rCMRGlc were found in both lower thalami reaching down to the midbrain area and remote from the stimulation site in the right frontal cortex, temporal cortex, and parietal cortex, whereas rCMRGlc significantly decreased in the left rostral cerebellum. Therefore, STN-DBS was found to suppress cerebellar hypermetabolism and to partly restore physiologic glucose consumption in limbic and associative projection territories of the basal ganglia. These data suggest an activating effect of DBS upon its target structures and confirm a central role of the STN in motor as well as associative, limbic, and cerebellar basal ganglia circuits.

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Section: Figmentioning

confidence: 64%

Subthalamic Nucleus Stimulation Restores Glucose Metabolism in Associative and Limbic Cortices and in Cerebellum: Evidence from a FDG-PET Study in Advanced Parkinson's Disease

Hilker¹,

Voges

Weisenbach

et al. 2004

J Cereb Blood Flow Metab

192

155

View full text Add to dashboard Cite

show abstract

“…There is evidence that DBS may also worsen depression and mania, increase apathy, affect emotional lability, and increase the risk of suicide (Berney et al, 2002;Doshi et al, 2002;Okun et al, 2003Okun et al, , 2009Funkiewiez et al, 2004;Smeding et al, 2005Smeding et al, , 2006Drapier et al, 2008;Voon et al, 2008). Mood problems are more common in patients treated with STN-DBS than those treated with GPi-DBS Follett et al, 2010;Moro et al, 2010;Bronstein et al, 2011).…”

Section: Non-motor Side Effects Of Stn and Gpi-dbsmentioning

confidence: 99%

Parkinson's Disease Therapeutics: New Developments and Challenges Since the Introduction of Levodopa

Smith

Wichmann

Factor

et al. 2011

Neuropsychopharmacol

194

137

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The demonstration that dopamine loss is the key pathological feature of Parkinson's disease (PD), and the subsequent introduction of levodopa have revolutionalized the field of PD therapeutics. This review will discuss the significant progress that has been made in the development of new pharmacological and surgical tools to treat PD motor symptoms since this major breakthrough in the 1960s. However, we will also highlight some of the challenges the field of PD therapeutics has been struggling with during the past decades. The lack of neuroprotective therapies and the limited treatment strategies for the nonmotor symptoms of the disease (ie, cognitive impairments, autonomic dysfunctions, psychiatric disorders, etc.) are among the most pressing issues to be addressed in the years to come. It appears that the combination of early PD nonmotor symptoms with imaging of the nigrostriatal dopaminergic system offers a promising path toward the identification of PD biomarkers, which, once characterized, will set the stage for efficient use of neuroprotective agents that could slow down and alter the course of the disease.

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“…There were 4 Class III studies [36][37][38][39] and 10 Class IV studies. [40][41][42][43][44][45][46][47][48][49] All studies examined bilateral DBS of the STN. Only the Class III studies are discussed in detail.…”

Section: Surgical Therapy Question 4: For Patients With Pd Does Dbsmentioning

confidence: 99%

“…[36][37][38][39][40][41]43,44,[46][47][48][49] Only the Class II studies are discussed in detail. Although these studies were rated Class IV relative to Question 4 regarding efficacy, they earned grades of Class II relative to prognosis for Question 5.…”

Section: Question 5: Which Factors Predict Improvement After Dbs?mentioning

confidence: 99%

Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

Pahwa¹,

Factor²,

Lyons³

et al. 2006

Neurology

463

314

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Depression leading to attempted suicide after bilateral subthalamic nucleus stimulation for Parkinson's disease

Cited by 162 publications

References 8 publications

Subthalamic Nucleus Stimulation Restores Glucose Metabolism in Associative and Limbic Cortices and in Cerebellum: Evidence from a FDG-PET Study in Advanced Parkinson's Disease

Subthalamic Nucleus Stimulation Restores Glucose Metabolism in Associative and Limbic Cortices and in Cerebellum: Evidence from a FDG-PET Study in Advanced Parkinson's Disease

Parkinson's Disease Therapeutics: New Developments and Challenges Since the Introduction of Levodopa

Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

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