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Fortschr Neurol Psychiatr 2014; 82(7): 386-393
DOI: 10.1055/s-0034-1366460
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Einfluss der Tiefen Hirnstimulation des Nucleus subthalamicus auf exekutive Funktionen bei Patienten mit idiopathischem Parkinson-Syndrom unter Berücksichtigung von Apathie, Depressivität und Stimmung

Executive Task Performance under Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson’s Disease Revisited: The Modulating Influence of Apathy, Depression and Mood
U. Lueken
1   Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
,
Y. Stankevich
1   Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
,
T. Goschke
2   Professur Allgemeine Psychologie, Technische Universität Dresden
,
T. E. Schläpfer
3   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn
,
J. Koy
4   Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
5   Neurochirurgie, Centre Hospitalier de Luxembourg
,
H. Reichmann
6   Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
,
A. Storch
6   Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
,
M. Wolz
6   Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
› Author Affiliations
Further Information

Publication History

12 March 2013

05 April 2014

Publication Date:
11 July 2014 (online)

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Zusammenfassung

In der vorliegenden Studie untersuchten wir den Einfluss von Apathie, Depression und transienten Stimmungsveränderungen auf exekutive Leistungen im optimierten medizinischen Zustand und unter Stimulation-on- und -off-Bedingungen postoperativ an 33 Patienten mit fortgeschrittenem idiopathischem Parkinson-Syndrom mit erfolgter Tiefer Hirnstimulation (THS) im Nucleus subthalamicus (STN), 33 Patienten mit rein medikamentöser Behandlung und 34 gesunden Probanden. Im Vergleich zur klinischen und gesunden Kontrollgruppe wiesen THS-Patienten nicht nur schlechtere exekutive Leistungen, sondern auch vermehrte Symptome von Depression und Apathie auf. Apathiesymptome erklärten Unterschiede in der Interferenzanfälligkeit zwischen den Gruppen. Effekte der Stimulation auf die Interferenzanfälligkeit konnten auf einen Anstieg der Zustandsängstlichkeit im -off zurückgeführt werden. Die Berücksichtigung neuropsychiatrischer Symptome und akuter Stimmungsveränderungen ist ein wichtiger Aspekt bei der Beurteilung möglicher neuropsychologischer Leistungsdefizite der Parkinsonerkrankung und der THS.

Abstract

We investigated the moderating influence of apathy, depression and transient mood changes on executive functions under best medical treatment and under postoperative stimulation-on and -off conditions in a sample of 33 patients with Parkinson’s disease (PD) after deep brain stimulation of the subthalamic nucleus (STN), 33 PD patients with pharmacological treatment only and 34 healthy controls. In comparison to clinical and healthy control groups, DBS patients showed worse executive task performance and also more severe symptoms of depression and apathy. Apathy accounted for differences in stroop interference between groups. The effects of DBS on stroop interference were explained by increased state anxiety in the -off, so that DBS STN had no significant influence on test performance. Consideration of neuropsychiatric symptoms and acute mood changes is an important aspect when evaluating neuropsychological deficits in DBS patients.

Schlüsselwörter

Morbus Parkinson - tiefe Hirnstimulation - Nucleus subthalamicus - exekutive Funktionen - Apathie - Depression

Key words

Parkinson’s disease - deep brain stimulation - subthalamic nucleus - executive functions - apathy - depression
 

  • Literatur

  • 1 Deuschl G, Schade-Brittinger C, Krack P et al. A Randomized Trial of Deep-Brain Stimulation for Parkinson's Disease. New Engl J Med 2006; 355: 896-908
    CrossrefPubMedSearch in Google Scholar
  • 2 Skuban T, Flohrer J, Klosterkötter J et al. Psychiatrische Nebenwirkungen der Tiefen Hirnstimulation bei idiopathischem Parkinsonsyndrom. Fortschr Neurol Psychiat 2011; 79: 703-710
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Smeding HMM, Speelman JD, Koning-Haanstra M et al. Predictors of cognitive and psychosocial outcome after STN DBS in Parkinson’s Disease. J Neurol Neurosurg Psychiatry 2011; 82: 754-760
    CrossrefPubMedSearch in Google Scholar
  • 4 Daniels C, Krack P, Volkmann J et al. Risk Factors For Executive Dysfunction After Subthalamic Nucleus Stimulation in Parkinson’'s Disease. Mov Dis 2010; 25: 1583-1589
    CrossrefPubMedSearch in Google Scholar
  • 5 Williams AE, Arzola GM, Strutt AM et al. Cognitive outcome and reliable change indices two years following bilateral subthalamic nucleus deep brain stimulation. Parkinsonism Relat Disord 2011; 17: 321-327
    CrossrefPubMedSearch in Google Scholar
  • 6 Morrison CE, Borod JC, Perrine K et al. Neuropsychological functioning following bilateral subthalamic nucleus stimulation in Parkinson’s disease. Arch Clin Neuropsychol 2004; 19: 165-181
    CrossrefPubMedSearch in Google Scholar
  • 7 Witt K, Daniels C, Reiff J et al. Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s diesease: a randomised, multicentre study. Lancet Neurol 2008; 7: 605-614
    CrossrefPubMedSearch in Google Scholar
  • 8 Castelli L, Rizzi L, Zibetti M et al. Neuropsychological changes 1-year after subthalamic DBS in PD patients: A prospective controlled study. Parkinsonism Relat Disord 2010; 16: 115-118
    CrossrefPubMedSearch in Google Scholar
  • 9 Yamanaka T, Ishii F, Umemura A et al. Temporary deterioration of executive function after subthalamic deep brain stimulation in Parkinson’s disease. Clin Neurol Neurosurg 2012; 114: 347-351
    CrossrefPubMedSearch in Google Scholar
  • 10 Hershey T, Revilla FJ, Wernle A et al. Stimulation of STN impairs aspects of cognitive control in PD. Neurology 2004; 62: 1110-1114
    CrossrefPubMedSearch in Google Scholar
  • 11 Jahanshahi M, Ardouin CMA, Brown RG et al. The impact of deep brain stimulation on executive function in Parkinson’s disease. Brain 2000; 123: 1142-1154
    CrossrefPubMedSearch in Google Scholar
  • 12 Witt K, Pulkowski U, Herzog J et al. Deep Brain Stimulation of the Subthalamic Nucleus Improves Cognitive Flexibility but Impairs Response Inhibition in Parkinson Disease. Arch Neurol 2004; 61: 697-700
    CrossrefPubMedSearch in Google Scholar
  • 13 Funkiewiez A, Ardouin C, Caputo E et al. Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behavior in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2004; 75: 834-839
    CrossrefPubMedSearch in Google Scholar
  • 14 Pillon B, Ardouin C, Damier P et al. Neuropsychological changes between “off” and “on” STN or GPi stimulation in Parkinson’s disease. Neurology 2000; 55: 411-418
    CrossrefPubMedSearch in Google Scholar
  • 15 Silveri MC, Ciccarelli N, Baldonero E et al. Effects of stimulation of the subthalamic nucleus on naming and reading nouns and verbs in Parkinson’s disease. Neuropsychologia 2012; 50: 1980-1989
    CrossrefPubMedSearch in Google Scholar
  • 16 Reijnders JSAM, Ehrt U, Weber WEJ et al. A Systematic Review of Prevalence Studies of Depression in Parkinson’s disease. Mov Disord 2008; 23: 183-189
    CrossrefPubMedSearch in Google Scholar
  • 17 Aarsland D, Marsch L, Schrag A. Neuropsychiatric Symptoms in Parkinson’s Disease. Mov Disord 2009; 24: 2175-2186
    CrossrefPubMedSearch in Google Scholar
  • 18 Poletti M, De Rosa A, Bonuccelli U. Affective symptoms and cognitive functions in Parkinson’s disease. J Neurolog Sci 2012; 317: 97-102
    CrossrefPubMedSearch in Google Scholar
  • 19 Butterfield LC, Cimino CR, Oelke LE et al. The Independent Influence of Apathy and Depression on Cognitive Functioning in Parkinson’s Disease. Neuropsychology 2010; 24: 721-730
    CrossrefPubMedSearch in Google Scholar
  • 20 Dujardin K, Sockeel P, Delliaux M et al. Apathy May Herald Cognitive Decline and Dementia in Parkinson’s Disease. Mov Disord 2009; 24: 2391-2397
    PubMedSearch in Google Scholar
  • 21 Starkstein SE. Apathy in Parkinson’s Disease: Diagnostic and Etiological Dilemmas. Mov Disord 2012; 27: 174-178
    CrossrefPubMedSearch in Google Scholar
  • 22 Maier F, Lewis CJ, Horskoetter N et al. Patients’ expectations of deep brain stimulation, subjective perceived outcome related to clinical measures in Parkinson’s disease: a mixed-method approach. J Neurol Neurosurg Psychiatry 2013; 84: 1273-1281
    CrossrefPubMedSearch in Google Scholar
  • 23 Coenen VA, Honey CR, Hurwitz T et al. Medial forebrain bundle stimulation as a pathophysiological mechanism for hypomania in subthalamic nucleus deep brain stimulation for Parkinson’s disease. Neurosurgery 64: 1106-1115
    PubMed
  • 24 Funkiewiez A, Ardouin C, Krack P et al. Acute Psychotropic Effects of Bilateral Subthalamic Nucleus Stimulation and Levodopa in Parkinson’s Disease. Mov Disord 18: 524-530
    PubMed
  • 25 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198
    CrossrefPubMedSearch in Google Scholar
  • 26 Saß H, Wittchen HU, Zaudig M et al. Diagnostisches und Statistisches Manual Psychischer Störungen Textrevision (DSM-IV-TR). Göttingen: Hogrefe; 2003
    CrossrefSearch in Google Scholar
  • 27 Wittchen HU, Pfister H. DIA-X-Interviews: Interviewheft Querschnittuntersuchung (DIA-X-12Monate); PC-Programm zur Durchführung des Interviews (Querschnittuntersuchung); Auswertungsprogramm. Frankfurt: Swets & Zeitlinger; 1997
    Search in Google Scholar
  • 28 Ishihara S. Ishihara's Tests For Colour Deficiency. 38 Plates Edition. Tokyo: Kanehara Trading Inc; 2005
    Search in Google Scholar
  • 29 Goetz CG, Poewe W, Rascol O et al. The Unified Parkinson’s Disease Rating Scale (UPDRS): Status and recommendations. Mov Disord 2003; 18: 738-750
    CrossrefPubMedSearch in Google Scholar
  • 30 Marin RS, Biedrzycki RC, Firinciogullari S. Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res 1991; 38: 143-162
    CrossrefPubMedSearch in Google Scholar
  • 31 Lueken U, Seidl U, Schwarz M et al. Psychometric properties of a German version of the Apathy Evaluation Scale. Fortschr Neurol Psychiatr 2006; 74: 714-722
    Thieme ConnectPubMedSearch in Google Scholar
  • 32 Montgomery SA, Asberg M. Montgomery Asberg Depression Scale. Göttingen: Beltz Test GmbH; 1988
    Search in Google Scholar
  • 33 Krohne HW, Egloff B, Kohlmann HW et al. Untersuchungen mit einer deutschen Version der „Positive and Negative Affective Schedule“ (PANAS). Diagnostica 1996; 42: 139-156
    PubMedSearch in Google Scholar
  • 34 Laux L, Glanzmann P, Schaffner P et al. State-Trait-Angstinventar (STAI). Theoretische Grundlagen und Handanweisung. Weinheim: Beltz; 1981
    Search in Google Scholar
  • 35 Kongs SK, Thompson LL, Iverson GL et al. Wisconsin Card Sorting Test-64. Göttingen: Hogrefe; 2000
    Search in Google Scholar
  • 36 Bäumler G. Farb-Wort-Interferenztest nach J. R. Stroop (FWIT). Göttingen: Hogrefe; 1984
    Search in Google Scholar
  • 37 Horn W. L-P-S Leistungsprüfsystem. Göttingen: Hogrefe; 1983
    Search in Google Scholar
  • 38 Rosenbaum PR, Rubin DB. The Central Role of the Propensity Score in Observational Studies for Causal Effects. Biometrika 1983; 70: 41-55
    CrossrefPubMedSearch in Google Scholar
  • 39 Dehejia RH, Wahba S. Propensity Score Matching Methods for Non-Experimental Causal Studies. Rev Econ Stat 2002; 84: 151-161
    CrossrefPubMedSearch in Google Scholar
  • 40 Varanese S, Perfetti B, Ghilardi MF et al. Apathy, but Not Depression, Reflects Inefficient Cognitive Strategies in Parkinson’s Disease. PLoS One 2011;
    PubMedSearch in Google Scholar
  • 41 Leentjens A, Verhey F, Lousberg R et al. The validity of the Hamilton and Montgomery-Asberg depression rating scales as screening and diagnostic tools for depression in Parkinson’s disease. Int J Geriatr Psychiatry 2000; 15: 644-649
    CrossrefPubMedSearch in Google Scholar
  • 42 Troster AI. Neuropsychology of deep brain stimulation in neurology and psychiatry. Front Biosci 2009; 14: 1857-1879
    PubMedSearch in Google Scholar
  • 43 Pluck GC, Brown RG. Apathy in Parkinson’s disease. Neurol Neurosurg Psychiatry 2002; 73: 636-642
    CrossrefPubMedSearch in Google Scholar
  • 44 Moretti R, Torre P, Antonello RM et al. Apathy: A Complex Symptom Specific to the Clinical Pattern of Presentation of Parkinson’s disease?. Am J Alzheimers Dis Other Demen 2012; 27: 196-201
    CrossrefPubMedSearch in Google Scholar
  • 45 Klepac N, Trkulja V, Relja M. Nondemented Parkinson disease patients: is cognitive performance associated with depressive difficulties?. Cogn Behav Neurol 2008; 21: 87-91
    CrossrefPubMedSearch in Google Scholar
  • 46 Fernandez HH, See RH, Gary MF et al. Depressive symptoms in Parkinson’s disease correlate with impaired global specific cognitive performance. J Geriatr Psychiatry Neurol 22: 223-227
    PubMed
  • 47 Costa A, Peppe A, Carlesimo GA et al. Major and minor depression in Parkinson’s disease: A neuropsychological investigation. Eur J Neurology 2006; 13: 972-980
    CrossrefPubMedSearch in Google Scholar