title: Mood and behavioural effects of subthalamic stimulation in Parkinson's disease.
abstract: Deep-brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for motor complications in Parkinson's disease. 20 years of experience with this procedure have contributed to improved understanding of the role of the STN in motor, cognitive, and emotional control. In Parkinson's disease, the pathological STN neuronal activity leads to motor, cognitive, and emotional inhibition. Deafferentation of the STN by DBS can reverse such behavioural inhibition. The release of this brake allows both motor and non-motor improvement, but can also be associated with excessive motor, cognitive, and emotional behavioural disinhibition. Conversely, the notable reduction in anti-parkinsonian drug dose allowed by motor improvement can unveil mesolimbic hypodopaminergic behaviours such as apathy, anxiety, or depression. Fine-tuning of stimulation parameters with dopaminergic drugs is necessary to prevent or improve pathological behaviours.
authors.affiliation: Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France; Clinica Neurologica, Università di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Castrioto
authors.affiliation: Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France.
authors.forename: Eugénie
authors.initials: E
authors.lastname: Lhommée
authors.affiliation: Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France.
authors.forename: Elena
authors.initials: E
authors.lastname: Moro
authors.affiliation: Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France. Electronic address: Paul.Krack@ujf-grenoble.fr.
authors.forename: Paul
authors.initials: P
authors.lastname: Krack
mesh_terms: D000339:Affect / Q000502:physiology*; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D020531:Subthalamic Nucleus / Q000502:physiology*