Irritability, psychomotor agitation and progressive insomnia induced by bilateral stimulation of the area surrounding the dorsal subthalamic nucleus (zona incerta) in Parkinson’s disease patients

Merello, Marcelo; Cavanagh, Sol; Pérez-Lloret, Santiago; Roldan, Eliana; Bruno, Verónica; Tenca, Eduardo; Leiguarda, R

doi:10.1007/s00415-009-5285-1

Cited by 10 publications

(3 citation statements)

References 15 publications

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“…The effects of STN and ZI DBS have been poorly documented to date. One report has shown that ZI DBS could improve anxiety and depression in PD patients (Burrows et al, 2012), while another has reported that either STN or ZI DBS could lead to psychiatric complications like irritability, psychomotor agitation and severe progressive insomnia (Merello et al, 2009). Our results suggest that this area should be taken into accounts carefully.…”

Section: Discussionmentioning

confidence: 99%

Decreased risk‐taking and loss‐chasing after subthalamic nucleus lesion in rats

Breysse

Meffre

Pelloux

et al. 2020

Eur J of Neuroscience

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The subthalamic nucleus (STN) is known to play a role in the control of impulsivity of action and in impulsivity of choice under certain conditions. In order to assess its influence on decision-making under uncertainty, we have tested here the effects of bilateral STN lesions in rats performing a probability discounting task (PDT) and a "loss-chasing" task, both tasks assessing risky decision under uncertainty, but one in a positive context (probability to obtain a larger reward) and the other in a negative context (risk for a larger loss). The PDT measures the choice between a small certain and a large uncertain reward. Conversely, in the "loss-chasing" task, animals choose between accepting a small certain loss versus risking a larger but uncertain penalty.The results show that STN lesions reduce risk-taking in both the PDT and the losschasing task, suggesting that STN inactivation could decrease risky decision-making whatever the nature of the outcome in an ambiguous context. Interestingly, opposite results were found in a small number of animals for which the lesions extended to the area dorsal to the STN (in the zona incerta), such that these animals increased choice of the uncertain option in the PDT. These results confirm the specificity of STN involvement in these processes and may provide explanations for some side-effects reported in patients when STN manipulations extend to the Zona Incerta. They also support the choice of the STN as a target for the treatment of impulse control disorders in Parkinson's disease and in obsessive compulsive disorders.

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Section: Discussionmentioning

confidence: 99%

Decreased risk‐taking and loss‐chasing after subthalamic nucleus lesion in rats

Breysse

Meffre

Pelloux

et al. 2020

Eur J of Neuroscience

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“…The importance of lead position was highlighted by Mercello and colleagues [25]. They presented two cases in which the area surrounding the dorsal STN (including the zona incerta) was stimulated as well as the STN itself.…”

Section: Deep Brain Stimulationmentioning

confidence: 97%

Parkinson’s disease and 2009: recent advances

Breen

Barker

2010

J Neurol

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“…Moreover, stimulation of the rostral ZI induced side effects in some patients, i.e. speech deterioration and a sense of disequilibrium during walking [47], as well as irritability, psychomotor agitation and severe progressive insomnia [48]. The former disturbances were not present after stimulation of the caudal ZI [47].…”

Section: Active Target For Dbs Outside the Stn: The Zimentioning

confidence: 99%

Zona incerta as a therapeutic target in Parkinson’s disease

Ossowska

2019

J Neurol

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The zona incerta has recently become an important target for deep-brain stimulation (DBS) in Parkinson's disease (PD). The present review summarizes clinical, animal and anatomical data which have indicated an important role of this structure in PD, and discusses potential mechanisms involved in therapeutic effects of DBS. Animal studies have suggested initially some role of neurons as well as GABAergic and glutamatergic receptors of the zona incerta in locomotion and generation of PD signs. Anatomical data have indicated that thanks to its multiple interconnections with the basal ganglia, thalamus, cerebral cortex, brainstem, spinal cord and cerebellum, the zona incerta is an important link in a neuronal chain transmitting impulses involved in PD pathology. Finally, clinical studies have shown that DBS of this structure alleviates parkinsonian bradykinesia, muscle rigidity and tremor. DBS of caudal zona incerta seemed to be the most effective therapeutic intervention, especially with regard to reduction of PD tremor as well as other forms of tremor.

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Irritability, psychomotor agitation and progressive insomnia induced by bilateral stimulation of the area surrounding the dorsal subthalamic nucleus (zona incerta) in Parkinson’s disease patients

Abstract: Fig. 2 Case 2: a MRI scans from both patients. b Schaltembradt atlas images have been superimposed to show DBS electrodes location. c UPDRS irritability and anxiety score changes with different stimulation parameters. d Sleep duration changes with different stimulation parameters

Cited by 10 publications

References 15 publications

Decreased risk‐taking and loss‐chasing after subthalamic nucleus lesion in rats

Decreased risk‐taking and loss‐chasing after subthalamic nucleus lesion in rats

Parkinson’s disease and 2009: recent advances

Zona incerta as a therapeutic target in Parkinson’s disease

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