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              <p>OBJECTIVE: The decrease in verbal fluency in patients with Parkinson's disease (PD) undergoing subthalamic nucleus deep brain stimulation (STN-DBS) is usually assumed to reflect a frontal lobe-related cognitive dysfunction, although evidence for this is lacking. METHODS: To explore its underlying mechanisms, we combined neuropsychological, psychiatric and motor assessments with an examination of brain metabolism using F-18 fluorodeoxyglucose positron emission tomography, in 26 patients with PD, 3 months before and after surgery. We divided these patients into two groups, depending on whether or not they exhibited a postoperative deterioration in either phonemic (10 patients) or semantic (8 patients) fluency. We then compared the STN-DBS groups with and without verbal deterioration on changes in clinical measures and brain metabolism. RESULTS: We did not find any neuropsychological change supporting the presence of an executive dysfunction in patients with a deficit in either phonemic or semantic fluency. Similarly, a comparison of patients with or without impaired fluency on brain metabolism failed to highlight any frontal areas involved in cognitive functions. However, greater changes in cognitive slowdown and apathy were observed in patients with a postoperative decrease in verbal fluency. CONCLUSIONS: These results suggest that frontal lobe-related cognitive dysfunction could play only a minor role in the postoperative impairment of phonemic or semantic fluency, and that cognitive slowdown and apathy could have a more decisive influence. Furthermore, the phonemic and semantic impairments appeared to result from the disturbance of distinct mechanisms.</p>
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          <date type="start">1559-01-01</date>
          <desc>
            <address>
              <addrLine>24 rue du Général-Dufour CH - 1211 Genève 4Suisse</addrLine>
              <country key="CH"/>
            </address>
            <ref type="url">http://www.unige.ch/</ref>
          </desc>
        </org>
        <org type="laboratory" xml:id="struct-33417" status="VALID">
          <orgName>Service de neurochirurgie [Rennes] = Neurosurgery [Rennes]</orgName>
          <desc>
            <address>
              <addrLine>CHU Rennes, 2 rue Henri Le Guilloux 35033 RENNES cedex 9</addrLine>
              <country key="FR"/>
            </address>
            <ref type="url">https://www.chu-rennes.fr/</ref>
          </desc>
          <listRelation>
            <relation active="#struct-301327" type="direct"/>
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        </org>
        <org type="laboratory" xml:id="struct-182223" status="VALID">
          <idno type="IdRef">177793767</idno>
          <idno type="RNSR">200416333R</idno>
          <idno type="ROR">https://ror.org/01f1amm71</idno>
          <orgName>Laboratoire Traitement du Signal et de l'Image</orgName>
          <orgName type="acronym">LTSI</orgName>
          <date type="start">2012-01-01</date>
          <desc>
            <address>
              <addrLine>Campus Universitaire de Beaulieu - Bât 22 - 35042 Rennes</addrLine>
              <country key="FR"/>
            </address>
            <ref type="url">https://ltsi.univ-rennes.fr</ref>
          </desc>
          <listRelation>
            <relation active="#struct-105160" type="direct"/>
            <relation name="UMR1099 / U1099" active="#struct-303623" type="direct"/>
          </listRelation>
        </org>
        <org type="laboratory" xml:id="struct-238034" status="VALID">
          <orgName>Service de Psychiatrie de l'adulte [Rennes]</orgName>
          <desc>
            <address>
              <addrLine>108 Avenue Général Leclerc - 35700 Rennes</addrLine>
              <country key="FR"/>
            </address>
          </desc>
          <listRelation>
            <relation active="#struct-105160" type="direct"/>
            <relation active="#struct-108091" type="direct"/>
            <relation active="#struct-356554" type="direct"/>
          </listRelation>
        </org>
        <org type="institution" xml:id="struct-301327" status="VALID">
          <idno type="ROR">https://ror.org/05qec5a53</idno>
          <orgName>Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]</orgName>
          <desc>
            <address>
              <addrLine>2 Rue Henri le Guilloux, 35000 Rennes</addrLine>
              <country key="FR"/>
            </address>
            <ref type="url">https://www.chu-rennes.fr/</ref>
          </desc>
        </org>
        <org type="institution" xml:id="struct-301510" status="VALID">
          <idno type="ROR">https://ror.org/01yezas83</idno>
          <orgName>CRLCC Eugène Marquis</orgName>
          <orgName type="acronym">CRLCC</orgName>
          <desc>
            <address>
              <addrLine>Avenue Bataille Flandres-Dunkerque 35042 RENNES CEDEX</addrLine>
              <country key="FR"/>
            </address>
            <ref type="url">http://www.centre-eugene-marquis.fr/</ref>
          </desc>
          <listRelation>
            <relation active="#struct-502406" type="direct"/>
          </listRelation>
        </org>
        <org type="regroupinstitution" xml:id="struct-502406" status="VALID">
          <orgName>UNICANCER</orgName>
          <desc>
            <address>
              <addrLine>101, rue de Tolbiac, 75654 Paris Cedex 13</addrLine>
              <country key="FR"/>
            </address>
            <ref type="url">http://www.unicancer.fr/</ref>
          </desc>
        </org>
        <org type="institution" xml:id="struct-105160" status="VALID">
          <idno type="IdRef">26693823X</idno>
          <idno type="ROR">https://ror.org/015m7wh34</idno>
          <orgName>Université de Rennes</orgName>
          <orgName type="acronym">UR</orgName>
          <desc>
            <address>
              <addrLine>Campus de Beaulieu, 263 avenue Général Leclerc, CS 74205, 35042 RENNES CEDEX</addrLine>
              <country key="FR"/>
            </address>
            <ref type="url">https://www.univ-rennes.fr/</ref>
          </desc>
        </org>
        <org type="institution" xml:id="struct-108091" status="OLD">
          <idno type="ROR">https://ror.org/033c46s90</idno>
          <orgName>Université européenne de Bretagne - European University of Brittany</orgName>
          <orgName type="acronym">UEB</orgName>
          <desc>
            <address>
              <addrLine>5 boulevard Laënnec - 35000 Rennes</addrLine>
              <country key="FR"/>
            </address>
            <ref type="url">http://www.ueb.eu/</ref>
          </desc>
        </org>
        <org type="institution" xml:id="struct-357205" status="VALID">
          <orgName>Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes</orgName>
          <orgName type="acronym">INCR</orgName>
          <desc>
            <address>
              <country key="FR"/>
            </address>
            <ref type="url">https://www.incr.fr/</ref>
          </desc>
        </org>
        <org type="institution" xml:id="struct-303623" status="VALID">
          <idno type="IdRef">026388278</idno>
          <idno type="ROR">https://ror.org/02vjkv261</idno>
          <orgName>Institut National de la Santé et de la Recherche Médicale</orgName>
          <orgName type="acronym">INSERM</orgName>
          <desc>
            <address>
              <addrLine>101, rue de Tolbiac, 75013 Paris</addrLine>
              <country key="FR"/>
            </address>
            <ref type="url">http://www.inserm.fr</ref>
          </desc>
        </org>
        <org type="institution" xml:id="struct-356554" status="INCOMING">
          <orgName>Centre Hospitalier Guillaume Régnier</orgName>
          <desc>
            <address>
              <country key="FR"/>
            </address>
          </desc>
        </org>
      </listOrg>
    </back>
  </text>
</TEI>