Structural and functional correlates of subthalamic deep brain stimulation-induced apathy in Parkinson’s disease
Background: Notwithstanding the large improvement in motor function in Parkinson’s disease (PD) patients treated with deep brain stimulation (DBS), apathy may increase. Postoperative apathy cannot always be related to a dose reduction of dopaminergic medication and stimulation itself may play a role...
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Elsevier
2021-01-01
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Series: | Brain Stimulation |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S1935861X20303119 |
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doaj-715d739f781e4157b27f2f57a1602e57 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lennard I. Boon Wouter V. Potters Thomas J.C. Zoon Odile A. van den Heuvel Naomi Prent Rob M.A. de Bie Maarten Bot P. Richard Schuurman Pepijn van den Munckhof Gert J. Geurtsen Arjan Hillebrand Cornelis J. Stam Anne-Fleur van Rootselaar Henk W. Berendse |
spellingShingle |
Lennard I. Boon Wouter V. Potters Thomas J.C. Zoon Odile A. van den Heuvel Naomi Prent Rob M.A. de Bie Maarten Bot P. Richard Schuurman Pepijn van den Munckhof Gert J. Geurtsen Arjan Hillebrand Cornelis J. Stam Anne-Fleur van Rootselaar Henk W. Berendse Structural and functional correlates of subthalamic deep brain stimulation-induced apathy in Parkinson’s disease Brain Stimulation Parkinson’s disease Deep brain stimulation Apathy Magnetoencephalography Functional connectivity |
author_facet |
Lennard I. Boon Wouter V. Potters Thomas J.C. Zoon Odile A. van den Heuvel Naomi Prent Rob M.A. de Bie Maarten Bot P. Richard Schuurman Pepijn van den Munckhof Gert J. Geurtsen Arjan Hillebrand Cornelis J. Stam Anne-Fleur van Rootselaar Henk W. Berendse |
author_sort |
Lennard I. Boon |
title |
Structural and functional correlates of subthalamic deep brain stimulation-induced apathy in Parkinson’s disease |
title_short |
Structural and functional correlates of subthalamic deep brain stimulation-induced apathy in Parkinson’s disease |
title_full |
Structural and functional correlates of subthalamic deep brain stimulation-induced apathy in Parkinson’s disease |
title_fullStr |
Structural and functional correlates of subthalamic deep brain stimulation-induced apathy in Parkinson’s disease |
title_full_unstemmed |
Structural and functional correlates of subthalamic deep brain stimulation-induced apathy in Parkinson’s disease |
title_sort |
structural and functional correlates of subthalamic deep brain stimulation-induced apathy in parkinson’s disease |
publisher |
Elsevier |
series |
Brain Stimulation |
issn |
1935-861X |
publishDate |
2021-01-01 |
description |
Background: Notwithstanding the large improvement in motor function in Parkinson’s disease (PD) patients treated with deep brain stimulation (DBS), apathy may increase. Postoperative apathy cannot always be related to a dose reduction of dopaminergic medication and stimulation itself may play a role. Objective: We studied whether apathy in DBS-treated PD patients could be a stimulation effect. Methods: In 26 PD patients we acquired apathy scores before and >6 months after DBS of the subthalamic nucleus (STN). Magnetoencephalography recordings (ON and OFF stimulation) were performed ≥6 months after DBS placement. Change in apathy severity was correlated with (i) improvement in motor function and dose reduction of dopaminergic medication, (ii) stimulation location (merged MRI and CT-scans) and (iii) stimulation-related changes in functional connectivity of brain regions that have an alleged role in apathy. Results: Average apathy severity significantly increased after DBS (p < 0.001) and the number of patients considered apathetic increased from two to nine. Change in apathy severity did not correlate with improvement in motor function or dose reduction of dopaminergic medication. For the left hemisphere, increase in apathy was associated with a more dorsolateral stimulation location (p = 0.010). The increase in apathy severity correlated with a decrease in alpha1 functional connectivity of the dorsolateral prefrontal cortex (p = 0.006), but not with changes of the medial orbitofrontal or the anterior cingulate cortex. Conclusions: The present observations suggest that apathy after STN-DBS is not necessarily related to dose reductions of dopaminergic medication, but may be an effect of the stimulation itself. This highlights the importance of determining optimal DBS settings based on both motor and non-motor symptoms. |
topic |
Parkinson’s disease Deep brain stimulation Apathy Magnetoencephalography Functional connectivity |
url |
http://www.sciencedirect.com/science/article/pii/S1935861X20303119 |
work_keys_str_mv |
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doaj-715d739f781e4157b27f2f57a1602e572021-03-19T07:23:25ZengElsevierBrain Stimulation1935-861X2021-01-01141192201Structural and functional correlates of subthalamic deep brain stimulation-induced apathy in Parkinson’s diseaseLennard I. Boon0Wouter V. Potters1Thomas J.C. Zoon2Odile A. van den Heuvel3Naomi Prent4Rob M.A. de Bie5Maarten Bot6P. Richard Schuurman7Pepijn van den Munckhof8Gert J. Geurtsen9Arjan Hillebrand10Cornelis J. Stam11Anne-Fleur van Rootselaar12Henk W. Berendse13Amsterdam UMC, Vrije Universiteit Amsterdam, Neurology, Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Clinical Neurophysiology and Magnetoencephalography Centre, Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Neurology and Clinical Neurophysiology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands; Corresponding author. Amsterdam UMC, location VUmc, Neurology, Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, the Netherlands.Amsterdam UMC, University of Amsterdam, Neurology and Clinical Neurophysiology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the NetherlandsAmsterdam UMC, University of Amsterdam, Psychiatry, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, the NetherlandsAmsterdam UMC, University of Amsterdam, Neurology and Clinical Neurophysiology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the NetherlandsAmsterdam UMC, University of Amsterdam, Neurology and Clinical Neurophysiology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the NetherlandsAmsterdam UMC, University of Amsterdam, Neurosurgery, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the NetherlandsAmsterdam UMC, University of Amsterdam, Neurosurgery, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the NetherlandsAmsterdam UMC, University of Amsterdam, Neurosurgery, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the NetherlandsAmsterdam UMC, University of Amsterdam, Medical Psychology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Amsterdam, Clinical Neurophysiology and Magnetoencephalography Centre, Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Amsterdam, Clinical Neurophysiology and Magnetoencephalography Centre, Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, the NetherlandsAmsterdam UMC, University of Amsterdam, Neurology and Clinical Neurophysiology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the NetherlandsAmsterdam UMC, Vrije Universiteit Amsterdam, Neurology, Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, the NetherlandsBackground: Notwithstanding the large improvement in motor function in Parkinson’s disease (PD) patients treated with deep brain stimulation (DBS), apathy may increase. Postoperative apathy cannot always be related to a dose reduction of dopaminergic medication and stimulation itself may play a role. Objective: We studied whether apathy in DBS-treated PD patients could be a stimulation effect. Methods: In 26 PD patients we acquired apathy scores before and >6 months after DBS of the subthalamic nucleus (STN). Magnetoencephalography recordings (ON and OFF stimulation) were performed ≥6 months after DBS placement. Change in apathy severity was correlated with (i) improvement in motor function and dose reduction of dopaminergic medication, (ii) stimulation location (merged MRI and CT-scans) and (iii) stimulation-related changes in functional connectivity of brain regions that have an alleged role in apathy. Results: Average apathy severity significantly increased after DBS (p < 0.001) and the number of patients considered apathetic increased from two to nine. Change in apathy severity did not correlate with improvement in motor function or dose reduction of dopaminergic medication. For the left hemisphere, increase in apathy was associated with a more dorsolateral stimulation location (p = 0.010). The increase in apathy severity correlated with a decrease in alpha1 functional connectivity of the dorsolateral prefrontal cortex (p = 0.006), but not with changes of the medial orbitofrontal or the anterior cingulate cortex. Conclusions: The present observations suggest that apathy after STN-DBS is not necessarily related to dose reductions of dopaminergic medication, but may be an effect of the stimulation itself. This highlights the importance of determining optimal DBS settings based on both motor and non-motor symptoms.http://www.sciencedirect.com/science/article/pii/S1935861X20303119Parkinson’s diseaseDeep brain stimulationApathyMagnetoencephalographyFunctional connectivity |