Rapid resolution of dopamine dysregulation syndrome (DDS) after subthalamic DBS for Parkinson disease (PD): a case report.

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State: Public
Version: author
Serval ID
serval:BIB_0DB46AA1C128
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Rapid resolution of dopamine dysregulation syndrome (DDS) after subthalamic DBS for Parkinson disease (PD): a case report.
Journal
Cognitive and behavioral neurology
Author(s)
Knobel D., Aybek S., Pollo C., Vingerhoets F.J., Berney A.
ISSN
1543-3641 (Electronic)
ISSN-L
1543-3633
Publication state
Published
Issued date
09/2008
Peer-reviewed
Oui
Volume
21
Number
3
Pages
187-189
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
To describe how subthalamic deep brain stimulation (STN-DBS) and reduction in dopamine replacement therapy (DRT) allowed rapid resolution of dopamine dysregulation syndrome (DDS) with severe behavioral disorder in a patient with late stage Parkinson disease (PD).
DDS was recently defined as compulsive use of dopaminergic drugs, associated with severe behavioral symptoms, and impaired social functioning, occurring in about 4% of PD patients under DRT. STN-DBS is an effective treatment for late stage PD with treatment resistant motor fluctuations, which frequently allows also to reduce DRT.
A late stage PD patient referred to our center for STN-DBS, suffering from severe DDS necessitating in-ward psychiatric management, was comprehensively assessed preoperatively and postoperatively for motor, cognitive, and psychiatric status.
Following subthalamic DBS procedure and medication reduction, we observed a rapid and dramatic resolution of DDS and associated psychiatric symptoms, allowing discharge from a 2-year stay in a psychiatric institution.
DDS occurring in late stage PD patients may be dramatically improved by STN-DBS, possibly in relation with the reduction of dopaminergic medication. In contrast to other psychiatric symptoms, DDS should not be considered as an obstacle to DBS procedure in late stage PD patients.

Keywords
Aggression/psychology, Antiparkinson Agents/therapeutic use, Deep Brain Stimulation/methods, Dopamine/physiology, Humans, Impulsive Behavior/psychology, Indoles/therapeutic use, Male, Middle Aged, Parkinson Disease/metabolism, Parkinson Disease/physiopathology, Parkinson Disease/therapy, Subthalamic Nucleus/physiology, Surveys and Questionnaires
Pubmed
Web of science
Create date
09/10/2008 14:54
Last modification date
06/12/2019 7:08
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