Parkinson’s disease: news on tremor, subthalamic stimulation and impulse control disorders

Abstract

This month’s Journal Club will focus on three recently published articles which deepen our knowledge in three fields of Parkinson’s disease (PD). The first article deals with the understanding of rest and postural tremors in PD. The authors found evidence that the excitability of the cerebellothalamocortical pathway is decreased in PD and seems to be involved in the generation or transmission of postural tremor. This article is accompanied by quite a critical editorial, which points out that there is still room for further discoveries. The second article deals with the effects of subthalamic stimulation on speech in consecutive patients with PD. It shows that, depending on the localisation of the electrodes, subthalamic stimulation can cause a significant deterioration of speech or improve loudness of speech. As in the study mentioned above on tremor, the cerebellothalamic tract seems also to be involved in speech deterioration. The third article shows that amantadine use is associated with impulse control disorders in PD, mainly due to its pro-dopaminergic activity, whereas its antiglutaminergic properties may even have a beneficial effect when amantadine is introduced in patients already suffering from impulse control disorders.