Explosive-aggressive behavior related to bilateral subthalamic stimulation

Sensi, Mariachiara; Eleopra, Roberto; Cavallo, Michele Alessandro; Sette, Elisabetta; Milani, Paola; Quatrale, R.; Capone, J.G.; Tugnoli, V.; Tola, Maria Rosaria; Granieri, Enrico; Data, P. G.

doi:10.1016/j.parkreldis.2004.01.007

Cited by 85 publications

(45 citation statements)

References 12 publications

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“…In contrast, there are several reports of ICDs that seem to be induced by DBS of the STN. [596][597][598] We recently evaluated consecutive patients with DBS-STN with the Minnesota Impulsive Disorders Interview and the Barrett Impulsivity Scale, and found an increased risk of ICDs and higher Minnesota Impulsive Disorders Interview scores in patients with DBS-STN, compared with age-matched medically treated patients with PD and healthy controls. 599 Overall, DBS provides dramatic benefits, particularly for patients with motor complications and the procedures are relatively well tolerated.…”

Section: Disadvantagesmentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

760

658

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Parkinson disease (PD) is an age-related neurodegenerative disorder that affects as many as 1-2% of persons aged 60 years and older. With the aging of the population, the frequency of PD is expected to increase dramatically in the coming decades. Current therapy is largely based on a dopamine replacement strategy, primarily using the dopamine precursor levodopa. However, chronic treatment is associated with the development of motor complications, and the disease is inexorably progressive. Further, advancing disease is associated with the emergence of features such as freezing, falling, and dementia which are not adequately controlled with dopaminergic therapies. Indeed, it is now appreciated that these nondopaminergic features are common and the major source of disability for patients with advanced disease. Many different therapeutic agents and treatment strategies have been evaluated over the past several years to try and address these unmet medical needs, and many promising approaches are currently being tested in the laboratory and in the clinic. As a result, there are now many new therapies and strategic approaches available for the treatment of the different stages of PD, with which the treating physician must be familiar in order to provide patients with optimal care. This monograph provides an overview of the management of PD patients, with an emphasis on pathophysiology, and the results of recent clinical trials. It is intended to provide physicians with an understanding of the different treatment options that are available for managing the different stages of the disease and the scientific rationale of the different approaches. 1 PD is the second most common neurodegenerative disorder, with an average age at onset of about 60 years. An estimated 5 million people throughout the world have PD, with 1 million individuals each in the United States and in Europe with the disorder. PD affects approximately 0.3% of the population and 1% to 2% of those older than 60 years.2 With the aging of the population and the substantial increase in the number of at-risk individuals older than 60 years, it is anticipated that the prevalence of PD will increase dramatically in the coming decades.

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Section: Disadvantagesmentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

760

658

View full text Add to dashboard Cite

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“…Transient acute depression induced by stimulation of the subthalamic region has also been described (Bejjani et al, 1999;Blomstedt et al, 2008;Tommasi et al, 2008b) and is suggested to be related to stimulation of the substantia nigra (Bejjani et al, 1999;Blomstedt et al, 2008) or of the zona incerta (Tommasi et al, 2008b). More rarely, stimulation can induce aggressive behavior, and this has been attributed to stimulation of fibers outside the STN in the nearby triangle of Sano (Bejjani et al, 2002b;Sensi et al, 2004), or to diffusion to the lateral part of the posteromedial hypothalamus. Alternatively, these behaviors (acute mania, depression, or aggressiveness), even though quite diverse, might all be specific to the limbic STN and represent disinhibition of normally controlled behavior (Frank et al, 2007;Krack et al, 2010).…”

Section: Postoperative Management Of Deep Brain Stimulation In Parkinmentioning

confidence: 98%

Postoperative management of deep brain stimulation in Parkinson’s disease

Castrioto

Volkmann

Krack

2013

Handbook of Clinical Neurology

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“…On the other hand, in some Parkinsonian patients, impulse control disorders appear after subthalamic implants, notwithstanding with a postoperative reduction of doses of dopaminergic drugs (Romito et al, 2002;Doshi and Bargava, 2008;Smeding et al, 2007;Sensi et al, 2004;Lim et al, 2009). In these latter patients, it might be hypothesised that deep brain stimulation of the subthalamic nucleus may induce changes in the activity of limbic circuits involving the subthalamic nucleus or involving fibres adjacent to this nucleus, giving rise to a tendency to impulsivity (Demetriades et al, 2011).…”

Section: Psychotic Symptoms: Treatment and Prognosismentioning

confidence: 99%