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Background:Mood symptoms negatively affect quality of life of Parkinson’s disease (PD); however little is known about the impact of behavioral disorders such as impulse control disorders, and non-motor fluctuations on quality of life. Objective:To assess the impact of mood and behavioral disorders on quality of life in PD. Methods:136 (84% male) PD were included (mean age: 61±8y; mean duration of disease: 8.8±5.4y). Mood symptoms, behavioral disorders and non-motor fluctuations were detected and quantified using the recently validated “Ardouin Scale of Behavior in Parkinson’s Disease”. Motor symptoms were assessed using UPDRS and quality of life with the “39-item Parkinson’s Disease Questionnaire”. Results:Both motor and non-motor factors significantly affected the quality of life of PD patients. Multivariate regression of the relationship between items of the quality of life questionnaire and the Ardouin Scale showed that alteration of patients’ quality of life was strongly correlated with the presence of mood symptoms (such as depression, anxiety ...) and with non-motor fluctuations (especially in the OFF period). A significant correlation was also found between the number of symptoms and their severity, and the quality of life deterioration. Some behavioral disorders (compulsive buying / eating behavior) also negatively affected patient’s quality of life to a lesser extent. Alternatively, excess in motivation and hobbyism behaviors had a positive impact on mobility and emotional well-being dimensions respectively of quality of life. Conclusions:This study shows the main impact of mood symptoms and non-motor fluctuations on worsening quality of life in PD.

To investigate the acute effect of subthalamic nuclei deep brain stimulation (STN-DBS) and levodopa on pain and tolerance thresholds in patients with Parkinson disease. We hypothesized that a modification of pain threshold after STN-DBS would suggest a central modification of pain perception, whereas the absence of pain threshold change after STN-DBS would correspond to a peripheral mechanism via a decrease of painful stimuli.

Abstract: Object Relationships between clinical effects, anatomy, and electrophysiology are not fully understood in DBS of the subthalamic region in Parkinson’s disease. We proposed an anatomic study based on direct image-guided stereotactic surgery with a multiple source data analysis. Materials and Methods A manual anatomic mapping was realized on coronal 1.5-Tesla MRI of 15 patients. Biological data were collected under local anesthesia: the spontaneous neuron activities and the clinical efficiency and the appearance of adverse effects. They were related to relevant current values (mA), the benefit threshold (bt, minimal current leading an clear efficiency), the adverse effect threshold (at, minimal current leading an adverse effect) and the stimulation margin (sm =  at − bt); they were matched with anatomy. Results We found consistent relationships between anatomy and biological data. The optimal stimulation parameters (low bt + high sm) were noted in the dorsolateral STN. The highest spontaneous neuron activity was found in the ventromedial STN. Dorsolateral (sensorimotor) STN seems the main DBS effector. The highest spontaneous neuron activity seems related to the anterior (rostral) ventromedial (limbic) STN. Conclusion 1.5 Tesla images provide sufficiently detailed subthalamic anatomy for image-guided stereotactic surgery and may aid in understanding DBS mechanisms.

Dans la maladie de Parkinson (MP), une association entre le Trouble Comportemental en Sommeil Paradoxal (TCSP) et les troubles du contrôle des impulsions (TCI), a été mise en évidence, suggérant une altération du système de récompense chez les MP–TCSP.

Dans la maladie de Parkinson (MP), une association entre le Trouble Comportemental en Sommeil Paradoxal (TCSP) et les troubles du contrôle des impulsions (TCI) a été mise en évidence, suggérant une altération du système de récompense chez les MP-TCSP. Notre objectif était d’étudier l’activation du système de récompense chez des patients parkinsoniens avec et sans TCSP.

Les premiers résultats du groupe français d’étude de la neurostimulation dans les dyskinésies tardives (STARDYS) ont suggéré l’efficacité de la stimulation bipallidale sur 10 patients suivis pendant 6 mois.

Peu d’études ont évalué les effets de la stimulation cérébrale profonde du noyau subthalamique (SCP-NST) sur le syndrome des jambes sans repos (SJSR) dans la maladie de Parkinson et leurs résultats sont contradictoires. En effet une amélioration du SJSR après SCP-NST est parfois rapportée alors que d’autres études retrouvent au contraire une émergence de SJSR en postopératoire. Il a été suggéré que la forte diminution des traitements dopaminergiques après la chirurgie puisse démasquer les symptômes de SJSR et expliquer l’apparition de SJSR observée après SCP-NST. Nous avons ici voulu identifier spécifiquement les facteurs associés au risque de développer un SJSR après SCP-NST afin de mieux comprendre les mécanismes à l’origine du SJSR dans la maladie de Parkinson.