Chronic stress-like syndrome as a consequence of medial site subthalamic stimulation in Parkinson's disease
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
25554999
DOI
10.1016/j.psyneuen.2014.12.001
PII: S0306-4530(14)00455-7
Knihovny.cz E-resources
- Keywords
- Anxiety, Cortisol, Deep brain stimulation, Stress, Subthalamic nucleus, Weight gain,
- MeSH
- Chronic Disease MeSH
- Adult MeSH
- Deep Brain Stimulation adverse effects MeSH
- Weight Gain physiology MeSH
- Hydrocortisone blood MeSH
- Middle Aged MeSH
- Humans MeSH
- Subthalamic Nucleus * surgery MeSH
- Parkinson Disease blood therapy MeSH
- Stress, Psychological * blood etiology MeSH
- Aged MeSH
- Anxiety * blood etiology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Hydrocortisone MeSH
Considering the functional organization of the subthalamic nucleus (STN), we hypothesized that subthalamic deep brain stimulation (STN-DBS) in Parkinson's disease might have a differential impact on the hypothalamic-pituitary-adrenal axis in relation to the position of active stimulating contact within the STN. In addition, we searched for any STN-DBS-related morning plasma cortisol changes in association with postoperative anxiety and weight gain. A plasma cortisol measurement was performed on the day of initiation of bilateral STN-DBS and repeated after 1 and 17 months in twenty patients with advanced Parkinson's disease. The body weight change and anxiety scores following the implantation were assessed as well. The electrode positions in the STN were determined on T1-weighted magnetic resonance images. After initiation of stimulation, cortisol levels significantly decreased and the cortisol changes after 1 and 17 months strongly correlated with the position of active contact in the subthalamic area. Patients with at least one contact located more medially in the STN experienced a significantly greater decrease of cortisol than those with one or both active contacts more laterally. Furthermore, the lower cortisol levels were strongly associated with higher trait anxiety and weight gain. These changes mimicked the effects of chronic stress and suggest the disturbing impact of STN-DBS on limbic and motivational systems.
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