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cally higher in AS Del and AS non-Del, but not in PWS the Netherlands; Amsterdam UMC, University of Amsterdam,
Del and PWS non-Del. Medical Psychology, Amsterdam Neuroscience, Meibergdreef
9, Amsterdam, the Netherlands
CONCLUSIONS Our results indicate that the patho-
physiological impact of the hemizygosity of GABAaR BACKGROUND Notwithstanding the large improve-
genes is lower in PWS than AS. UBE3A deficiency and ment in motor function in Parkinson's disease (PD) pa-
the hemizygosity of GABAaR genes could synergistical- tients treated with deep brain stimulation (DBS), apathy
ly deteriorate neuronal function, resulting in aberrant may increase. Postoperative apathy cannot always be
SEFs in AS Del. related to a dose reduction of dopaminergic medica-
tion and stimulation itself may play a role.
Keywords: Angelman syndrome, GABA receptors, Prader-
Willi syndrome, Somatosensory-evoked magnetic fields OBJECTIVE We studied whether apathy in DBS-treated
PD patients could be a stimulation effect.
Brain & development (2021), Vol. 43, No. 4 (33419637) (1
citation) METHODS In 26 PD patients we acquired apathy scores
before and >6 months after DBS of the subthalamic
nucleus (STN). Magnetoencephalography recordings
Structural and functional correlates of subthalamic (ON and OFF stimulation) were performed ≥6 months
deep brain stimulation-induced apathy in after DBS placement. Change in apathy severity was
Parkinson's disease (2021) correlated with (i) improvement in motor function and
dose reduction of dopaminergic medication, (ii) stimu-
Boon, Lennard I; Potters, Wouter V; Zoon, Thomas J lation location (merged MRI and CT-scans) and (iii)
C; van den Heuvel, Odile A; Prent, Naomi; de Bie, Rob stimulation-related changes in functional connectivity
M A; Bot, Maarten; Schuurman, P Richard; van den of brain regions that have an alleged role in apathy.
Munckhof, Pepijn; Geurtsen, Gert J; Hillebrand, Arjan;
Stam, Cornelis J; van Rootselaar, Anne-Fleur; Berendse, RESULTS Average apathy severity significantly in-
Henk W creased after DBS (p < 0.001) and the number of
patients considered apathetic increased from two to
Amsterdam UMC, Vrije Universiteit Amsterdam, Neurology, nine. Change in apathy severity did not correlate with
Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, improvement in motor function or dose reduction of
the Netherlands; Amsterdam UMC, Vrije Universiteit Amster- dopaminergic medication. For the left hemisphere,
dam, Clinical Neurophysiology and Magnetoencephalogra- increase in apathy was associated with a more dorso-
phy Centre, Amsterdam Neuroscience, De Boelelaan, 1117, lateral stimulation location (p = 0.010). The increase in
Amsterdam, the Netherlands; Amsterdam UMC, University apathy severity correlated with a decrease in alpha1
of Amsterdam, Neurology and Clinical Neurophysiology, functional connectivity of the dorsolateral prefrontal
Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the cortex (p = 0.006), but not with changes of the medial
Netherlands. Electronic address: l.i.boon@amsterdamumc. orbitofrontal or the anterior cingulate cortex.
nl; Amsterdam UMC, University of Amsterdam, Psychiatry,
Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the CONCLUSIONS The present observations suggest that
Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, apathy after STN-DBS is not necessarily related to dose
Psychiatry, Amsterdam Neuroscience, De Boelelaan, 1117, reductions of dopaminergic medication, but may be
Amsterdam, the Netherlands; Amsterdam UMC, Vrije Univer- an effect of the stimulation itself. This highlights the
siteit Amsterdam, Anatomy and Neurosciences, Amsterdam importance of determining optimal DBS settings based
Neuroscience, De Boelelaan, 1117, Amsterdam, the Nether- on both motor and non-motor symptoms.
lands; Amsterdam UMC, University of Amsterdam, Neurosur-
gery, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam,

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