Preoperative factors of apathy in subthalamic stimulated Parkinson disease: a PET study

Neurology. 2014 Oct 28;83(18):1620-6. doi: 10.1212/WNL.0000000000000941. Epub 2014 Sep 24.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Apathy / physiology*
  • Deep Brain Stimulation / adverse effects*
  • Deep Brain Stimulation / instrumentation
  • Deep Brain Stimulation / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / metabolism*
  • Parkinson Disease / physiopathology
  • Parkinson Disease / therapy
  • Positron-Emission Tomography / methods*
  • Preoperative Period*
  • Subthalamic Nucleus / physiology*
  • Subthalamic Nucleus / surgery
  • Ventral Striatum / metabolism*
  • Ventral Striatum / physiopathology