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Abstract
Objective: The current literature provides discrepant results regarding preoperative sociodemographic and clinical factors, and no information about preoperative cerebral metabolic patterns associated with apathy after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson disease.
Methods: To resolve this issue, we set out to identify preoperative metabolic patterns and sociodemographic and clinical factors associated with increased apathy after STN-DBS. Forty-four patients with Parkinson disease were enrolled in this study. They all underwent STN-DBS. Metabolic activity was assessed with F-18 fluorodeoxyglucose PET 3 months before surgery. Apathy was assessed on the Apathy Evaluation Scale 3 months before and after STN-DBS. We controlled for preoperative age, levodopa therapy, and overall cognitive functions.
Results: Increased apathy after STN-DBS was significantly associated with reduced preoperative metabolism within the right ventral striatum. None of the sociodemographic and clinical variables tested were associated with apathy after STN-DBS.
Conclusions: Preoperative PET, but not sociodemographic or clinical factors, is associated with apathy after STN-DBS.
GLOSSARY
- AES=
- Apathy Evaluation Scale;
- AMDP-TA=
- Association for Methodology and Documentation in Psychiatry–Trait Anxiety;
- A-STN-DBS=
- subthalamic nucleus deep brain stimulation postoperative apathy;
- DRT=
- dopamine replacement therapy;
- 18-FDG-PET=
- F-18 fluorodeoxyglucose PET;
- GLM=
- general linear model;
- LEDD=
- levodopa equivalent daily dose;
- MCST=
- Modified Card Sorting Test;
- MDRS=
- Mattis Dementia Rating Scale;
- PD=
- Parkinson disease;
- ROI=
- region of interest;
- STN-DBS=
- subthalamic nucleus deep brain stimulation;
- TMT=
- Trail Making Test;
- UPDRS-III=
- Unified Parkinson's Disease Rating Scale–III;
- VS=
- ventral striatum;
- WFU=
- Wake Forest University
Footnotes
↵* These authors contributed equally to this work.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received March 5, 2014.
- Accepted in final form July 29, 2014.
- © 2014 American Academy of Neurology
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