Subthalamic nucleus stimulation induces deficits in decoding emotional facial expressions in Parkinson’s disease
- 1Neurology and Movement Disorders Unit, EA2683, University of Lille 2 and Lille University Hospital, Lille, France
- 2Neurosurgery Department, EA2683, University of Lille 2 and Lille University Hospital, Lille, France
- 3Psychiatry Department, Brugmann University Hospital, Brussels, Belgium
- 4Psychology Department, University of Quebec at Montreal, Montreal, Canada
- Correspondence to: Dr Kathy Dujardin Neurologie et Pathologie du Mouvement, Neurologie A, Hôpital Salengro, Centre Hospitalier Universitaire, F-59037 Lille Cedex, France; dujardinuniv-lille3.fr
- Received 4 March 2003
- Accepted 19 June 2003
- Revised 19 June 2003
Abstract
Background: Bilateral subthalamic nucleus (STN) stimulation is recognised as a treatment for parkinsonian patients with severe levodopa related motor complications. Although adverse effects are infrequent, some behavioural disturbances have been reported.
Objective: To investigate the consequences of STN stimulation on emotional information processing in Parkinson’s disease by assessing the performance of an emotional facial expression (EFE) decoding task in a group of patients before and after surgery.
Methods: 12 non-demented patients with Parkinson’s disease were studied. They were assessed one month before surgery and three months after. Their ability to decode EFEs was assessed using a standardised quantitative task. Overall cognitive function, executive function, visuospatial perception, depression, and anxiety were also measured. Twelve healthy controls were matched for age, sex, and duration of education.
Results: Before surgery, the patients showed no impairment in EFE decoding compared with the controls. Their overall cognitive status was preserved but they had a moderate dysexecutive syndrome. Three months after surgery, they had significant impairment of EFE decoding. This was not related to their overall cognitive status or to depression/anxiety scores. Visuospatial perception was not impaired. There was no change in the extent of the dysexecutive syndrome except for a reduction in phonemic word fluency.
Conclusions: Bilateral STN stimulation disturbs negative emotional information processing in Parkinson’s disease. The impairment appears specific and unrelated to certain secondary variables. This behavioural complication of STN may have implications for the patient’s social life.
- AC, anterior commissure
- AMDP-AT, Association of Methodology and Documentation in Psychiatry-anxiety
- DRS, dementia rating scale
- EFE, emotional facial expression
- MADRS, Montgomery and Asberg dementia rating scale
- MMSE, mini-mental state examination
- PC, posterior commissure
- STN, subthalamic nucleus
- UPDRS, unified Parkinson’s disease rating scale
- WAIS-R, Wechsler adult intelligence scale, revised
