Subthalamic nucleus stimulation in Parkinson disease induces apathy: a PET study.
OBJECTIVE
Apathy may be induced by subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson disease (PD). We therefore wished to test the hypothesis that apathy induced by STN-DBS correlates with changes in glucose metabolism, using (18)FDG-PET.


METHODS
Twelve patients with PD were assessed 3 months before (M-3) and 3 months after (M+3) STN-DBS with (18)FDG-PET and the Apathy Evaluation Scale.


RESULTS
Apathy had significantly worsened at M+3 after STN-DBS. Positive correlations were observed between this variation in apathy scores and changes in glucose metabolism, especially in the right frontal middle gyrus (Brodmann area [BA] 10) and right inferior frontal gyrus (BA 46 and BA 47). Negative correlations between the two were observed in the right posterior cingulate gyrus (BA 31) and left medial frontal lobe (BA 9).


CONCLUSIONS
These preliminary results confirm the role of the subthalamic nucleus in associative and limbic circuitry in humans and suggest that it is a key basal ganglia structure in motivation circuitry.
Le Jeune
F
F
Service de Médecine Nucléaire, Centre Eugéne Marquis, Renne, France.
Drapier
D
D
Bourguignon
A
A
Péron
J
J
Mesbah
H
H
Drapier
S
S
Sauleau
P
P
Haegelen
C
C
Travers
D
D
Garin
E
E
Malbert
C H
CH
Millet
B
B
Vérin
M
M
D000368:Aged; D001931:Brain Mapping; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D003863:Depression / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D049268:Positron-Emission Tomography; D013223:Statistics as Topic; D020531:Subthalamic Nucleus / Q000502:physiology*; D013997:Time Factors
D019788:Fluorodeoxyglucose F18