Dr. Gabriel Robert is a fellow at the Institute of Psychiatry in London. He has been a lecturer in Psychiatry for 3 years at the University of Rennes. Dr. Robert's main interests are the cerebral bases of apathy in neuropsychiatric disorders and particularly in Parkinson's Disease. His current project is to develop imaging in the field of geriatric psychiatry and to highlight imaging phenotypes that could help predict subsequent cognitive decline.

TITLE: Metabolic pattern associated with apathy following subthalamic nucleus - deep brain stimulation in Parkinson's Disease

Abstract:
Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) has marked improvement on motor symptoms but psychiatric side effects have been described such as apathy. Current literature provides no clues to identify pre-operative at-risk individuals. In order to resolve this issue we proposed to identify metabolic patterns associated with apathy increase before and after STN-DBS. Forty-two Parkinson’s Disease patients were enrolled in this study. They all underwent STN-DBS.

Metabolic activity was assessed with 18-Fluoro-Deoxy Glucose Positron Emission Tomography (18-FDG-PET) 3 months before surgery. Apathy was assessed with the Apathy Evaluation Scale (AES) 3 months before and after STN-DBS. Age, levodopa therapy and global cognitive functions were controlled. Increased apathy following STN-DBS was significantly associated with reduced preoperative metabolism within right ventral striatum. These results could define more precisely which patients are at-risk to develop post operative apathy and may help clinicians in their decision-making towards STN-DBS selection criteria.

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