Unilateral and Bilateral Subthalamic Deep Brain Stimulation Differently Favour Apathy in Parkinson's Disease Article Swipe
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1111/ejn.70019
· OA: W4407714802
The link between subthalamic nucleus deep brain stimulation (STN‐DBS) and apathy in patients with Parkinson's disease (PD) remains a controversial topic. The literature is mixed and the most supported explanation is the reduction of dopaminergic treatment. Yet a body of clinical and experimental evidences suggest that STN‐DBS itself can also promote apathy in certain patients. However, the parameters accounting for apathy heterogeneity in stimulated patients along with the mechanisms underlying apathy induced by STN‐DBS remain to be investigated. Whether bilateral and unilateral STN‐DBS have the same influence on apathy is for instance unknown. We previously and separately showed in patients and rodents that bilateral STN‐DBS can promote apathy per se. Here, we compare the effect of bilateral versus unilateral STN‐DBS both in patients and in rodents. We conducted a clinical follow‐up of patients with Parkinson's disease undergoing unilateral or bilateral STN‐DBS and assessing apathy 3 months before and after STN‐DBS. In parallel, we applied chronic and uninterrupted unilateral or bilateral DBS in rodents and extract longitudinal motivational changes with a battery of behavioural tests. While bilateral STN‐DBS promotes apathy in patients and induces a loss of motivation in rodents, we found that unilateral STN‐DBS did not exert such an effect both in patients and in rats. These data show that bilateral but not unilateral STN‐DBS promotes apathy. This not only substantiate the induction of neuropsychiatric effects by STN‐DBS but also suggest that this might be circumvented if STN‐DBS is applied unilaterally instead of bilaterally.
