0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

Effect of Pallidal Deep Brain Stimulation on Psychiatric Symptoms in Myoclonus-Dystonia due to ε-Sarcoglycan Mutations—Reply

David Grabli, MD, PhD; Emmanuel Roze, MD, PhD; Julie Azoulay-Zyss, MD; Marie Vidailhet, MD
Arch Neurol. 2011;68(8):1087-1089. doi:10.1001/archneurol.2011.181.
Text Size: A A A
Published online

Extract

In reply

Contarino et al describe the effect of bilateral DBS of the GPi in 5 patients with M-D due to SGCE mutations and point out the frequent occurrence of psychiatric worsening after surgery. Their results confirm the strong motor improvement for both myoclonus and dystonia in GPi-DBS–treated patients. The 5 patients had been evaluated by a trained neuropsychologist using a structured clinical interview that allowed comprehensive psychiatric monitoring before surgery and throughout follow-up. Unfortunately, use of a psychiatric structured interview was not part of the systematic assessment in our study, given the absence of behavioral adverse effects of GPi-DBS in our experience1,2 and according to the literature.3 This is because the psychiatric vulnerability of patients with M-D due to SGCE mutations had been previously recognized4 and, according to our clinical routine for DBS, these 5 patients were examined by a trained psychiatrist before surgery at the 9- to 12-months assessment and more frequently if necessary. At baseline, all of the patients had mild generalized anxiety and only 1 had a major depressive episode. No clinically meaningful psychiatric adverse effect was identified during the 18-month follow-up. According to patients' self-evaluation, anxiety was improved. There is no univocal explanation for such a discrepancy. It may be related to different psychiatric characteristics of the patients included in the 2 studies or with GPi-DBS–related effects. Modification of the pharmacological treatment after surgery might also have played a role in the psychiatric worsening observed in the patients reported by Contarino et al.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

August 1, 2011
Maria Fiorella Contarino, MD; Elisabeth M. Foncke, MD, PhD; Danielle C. Cath, MD, PhD; P. Richard Schuurman, MD, PhD; Johannes D. Speelman, MD, PhD; Marina A. J. Tijssen, MD, PhD
Arch Neurol. 2011;68(8):1087-1089. doi:10.1001/archneurol.2011.180.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

17 Views
9 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
Jobs
brightcove.createExperiences();