{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:35:33Z","timestamp":1791606933282,"version":"4.3.4"},"reference-count":76,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100008211","name":"France Parkinson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008211","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004571","name":"French Ministry of Social Affairs and Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004571","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Postoperative apathy is a frequent symptom in Parkinson\u2019s disease patients who have undergone bilateral deep brain stimulation of the subthalamic nucleus. Two main hypotheses for postoperative apathy have been suggested: (i) dopaminergic withdrawal syndrome relative to postoperative dopaminergic drug tapering; and (ii) direct effect of chronic stimulation of the subthalamic nucleus.<\/jats:p>\n                  <jats:p>The primary objective of our study was to describe preoperative and 1-year postoperative apathy in Parkinson\u2019s disease patients who underwent chronic bilateral deep brain stimulation of the subthalamic nucleus. We also aimed to identify factors associated with 1-year postoperative apathy considering: (i) preoperative clinical phenotype; (ii) dopaminergic drug management; and (iii) volume of tissue activated within the subthalamic nucleus and the surrounding structures.<\/jats:p>\n                  <jats:p>We investigated a prospective clinical cohort of 367 patients before and 1\u2005year after chronic bilateral deep brain stimulation of the subthalamic nucleus. We assessed apathy using the Lille Apathy Rating Scale and carried out a systematic evaluation of motor, cognitive and behavioural signs. We modelled the volume of tissue activated in 161 patients using the Lead-DBS toolbox and analysed overlaps within motor, cognitive and limbic parts of the subthalamic nucleus. Of the 367 patients, 94 (25.6%) exhibited 1-year postoperative apathy: 67 (18.2%) with \u2018de novo apathy\u2019 and 27 (7.4%) with \u2018sustained apathy\u2019. We observed disappearance of preoperative apathy in 22 (6.0%) patients, who were classified as having \u2018reversed apathy\u2019. Lastly, 251 (68.4%) patients had neither preoperative nor postoperative apathy and were classified as having \u2018no apathy\u2019. We identified preoperative apathy score [odds ratio (OR) 1.16; 95% confidence interval (CI) 1.10, 1.22; P &amp;lt; 0.001], preoperative episodic memory free recall score (OR 0.93; 95% CI 0.88, 0.97; P = 0.003) and 1-year postoperative motor responsiveness (OR 0.98; 95% CI 0.96, 0.99; P = 0.009) as the main factors associated with postoperative apathy. We showed that neither dopaminergic dose reduction nor subthalamic stimulation were associated with postoperative apathy. Patients with \u2018sustained apathy\u2019 had poorer preoperative fronto-striatal cognitive status and a higher preoperative action initiation apathy subscore. In these patients, apathy score and cognitive status worsened postoperatively despite significantly lower reduction in dopamine agonists (P = 0.023), suggesting cognitive dopa-resistant apathy. Patients with \u2018reversed apathy\u2019 benefited from the psychostimulant effect of chronic stimulation of the limbic part of the left subthalamic nucleus (P = 0.043), suggesting motivational apathy.<\/jats:p>\n                  <jats:p>Our results highlight the need for careful preoperative assessment of motivational and cognitive components of apathy as well as executive functions in order to better prevent or manage postoperative apathy.<\/jats:p>","DOI":"10.1093\/brain\/awad324","type":"journal-article","created":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T08:02:14Z","timestamp":1696060934000},"page":"472-485","source":"Crossref","is-referenced-by-count":28,"title":["Motivational and cognitive predictors of apathy after subthalamic nucleus stimulation in Parkinson\u2019s disease"],"prefix":"10.1093","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0769-0289","authenticated-orcid":false,"given":"Matthieu","family":"B\u00e9reau","sequence":"first","affiliation":[{"name":"Department of Neurology, NS-PARK\/F-CRIN network, University Hospital of Besan\u00e7on , 25030 Besan\u00e7on Cedex , France"},{"name":"UR LINC 481, Universit\u00e9 de Franche-Comt\u00e9 , F-2500 Besan\u00e7on , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Kibleur","sequence":"additional","affiliation":[{"name":"LIP\/PC2S, Universit\u00e9 Grenoble Alpes, Universit\u00e9 Savoie Mont Blanc , 38040 Grenoble Cedex 9 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Servant","sequence":"additional","affiliation":[{"name":"UR LINC 481, Universit\u00e9 de Franche-Comt\u00e9 , F-2500 Besan\u00e7on , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautier","family":"Cl\u00e9ment","sequence":"additional","affiliation":[{"name":"Department of Neurology, NS-PARK\/F-CRIN network, University Hospital of Besan\u00e7on , 25030 Besan\u00e7on Cedex , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Dujardin","sequence":"additional","affiliation":[{"name":"Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park\/F-CRIN network, Univ. Lille , 59037 Lille , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sophie","family":"Rolland","sequence":"additional","affiliation":[{"name":"Lille Neurosciences and Cognition, CHU-Lille, Department of Medical Pharmacology, NS-Park\/F-CRIN, Univ. Lille, Inserm , 59045 Lille , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Wirth","sequence":"additional","affiliation":[{"name":"Service de Neurologie, NS-Park\/F-CRIN network, H\u00f4pitaux Universitaires de Strasbourg et F\u00e9d\u00e9ration de M\u00e9decine Translationnelle de M\u00e9decine de Strasbourg , 67200 Strasbourg , France"},{"name":"Institut de G\u00e9n\u00e9tique et de Biologie Mol\u00e9culaire et Cellulaire, INSERM-U964\/CNRS-UMR7104\/Universit\u00e9 de Strasbourg , 67400 Illkirch , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ouhaid","family":"Lagha-Boukbiza","sequence":"additional","affiliation":[{"name":"Service de Neurologie, NS-Park\/F-CRIN network, H\u00f4pitaux Universitaires de Strasbourg et F\u00e9d\u00e9ration de M\u00e9decine Translationnelle de M\u00e9decine de Strasbourg , 67200 Strasbourg , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Voirin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, NS-PARK\/F-CRIN network, Strasbourg University Hospital , 67200 Strasbourg , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie des Neiges","family":"Santin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, NS-PARK\/F-CRIN network, Strasbourg University Hospital , 67200 Strasbourg , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elodie","family":"Hainque","sequence":"additional","affiliation":[{"name":"Assistance publique H\u00f4pitaux de Paris, Inserm, CNRS, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, Department of Neurology, NS-Park\/F-CRIN network, Sorbonne Universit\u00e9, Paris Brain Institute\u2014ICM , 75014 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Grabli","sequence":"additional","affiliation":[{"name":"Assistance publique H\u00f4pitaux de Paris, Inserm, CNRS, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, Department of Neurology, NS-Park\/F-CRIN network, Sorbonne Universit\u00e9, Paris Brain Institute\u2014ICM , 75014 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Comte","sequence":"additional","affiliation":[{"name":"UR LINC 481, Universit\u00e9 de Franche-Comt\u00e9 , F-2500 Besan\u00e7on , France"},{"name":"Centre d'investigation clinique Inserm CIC 1431, CHU Besan\u00e7on , F-25000 Besan\u00e7on , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Drapier","sequence":"additional","affiliation":[{"name":"Department of Neurology, NS-PARK\/F-CRIN network, University Hospital of Rennes , 35000 Rennes , 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Lille, Inserm , 59045 Lille , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Thobois","sequence":"additional","affiliation":[{"name":"Service de Neurologie C, NS-Park\/F-CRIN network, Hospices Civils de Lyon, H\u00f4pital Neurologique Pierre Wertheimer , 69500 Bron , France"},{"name":"Institut des Sciences Cognitives Marc Jeannerot, CNRS, UMR5229 , 69675 Bron , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3801-5297","authenticated-orcid":false,"given":"Maxime","family":"Desmarets","sequence":"additional","affiliation":[{"name":"Centre d'investigation clinique Inserm CIC 1431, CHU Besan\u00e7on , F-25000 Besan\u00e7on , France"},{"name":"Universit\u00e9 de Franche-Comt\u00e9, EFS, INSERM, UMR RIGHT , 25000 Besan\u00e7on , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Anheim","sequence":"additional","affiliation":[{"name":"Service de Neurologie, NS-Park\/F-CRIN network, H\u00f4pitaux Universitaires de Strasbourg et F\u00e9d\u00e9ration de M\u00e9decine Translationnelle de M\u00e9decine de Strasbourg , 67200 Strasbourg , France"},{"name":"Institut de G\u00e9n\u00e9tique et de Biologie Mol\u00e9culaire et Cellulaire, INSERM-U964\/CNRS-UMR7104\/Universit\u00e9 de Strasbourg , 67400 Illkirch , France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"key":"2024020201402893300_awad324-B1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.eurpsy.2018.07.008","article-title":"Is it time to revise the diagnostic criteria for apathy in brain disorders? 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