Amotivational Syndrome and Fatigue in Neurosurgery

Study Overview
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Brief Summary
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Depression is a major public concern associated with profound distress, intense suffering, and impairment in social, professional and familial functioning. Among the numerous symptoms defining depression, fatigue and motivation are not only frequent but also highly associated with poor quality of life and resistance to conventional antidepressant. Recent data, mainly obtained in animals, suggest that these symptoms may be linked to inflammatory processes within the central nervous system. Yet access to the brain is too invasive for exploring this link in patients with psychiatric conditions. However, certain conditions in neurosurgery, such as aneurysm rupture, require external evacuation, over several days or weeks, of the fluid bathing the brain through a catheter directly inserted into it. Critically, these patients also exhibit extreme exhaustion and fluctuating motivation, allowing to investigate the involvement of neuroinflammation in lack of motivation and fatigue by carrying out repeated motivation assessments with short behavioral tests (around ten minutes), while performing an analysis of inflammation markers in the fluid evacuated from the brain. The identification of inflammatory mechanisms underlying lack of motivation and fatigue could lead to the development of treatments for both resistant depression and motivation deficits that largely hamper rehabilitation in neurosurgery.

Official Title
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Amotivational Syndrome and Fatigue in Neurosurgery: The Impact of Neuroinflammation

Conditions
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Cerebral Injury, Motivation, Fatigue

Intervention / Treatment
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* Other: Assessment of the Motivational State


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >= 18 years old Patients required an external cerebrospinal fluid drainage Exclusion Criteria: Pregnant or breast feeding patient Patient under legal protection Patient opposition to participate in this study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 95 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Amotivational Syndrome<br>Patients required an external drainage of the cerebrospinal fluid. | Other: Assessment of the Motivational State<br>* A motivational interviewing algorithm developed in Rothschild Hospital for this study will be used. The results range between 0% (worst motivational state) to 100% (best motivational state).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nerotransmitter levels in cerebrospinal fuid in relation to patient motivational condition | Study the correlation between serotonin, dopamin and glutamate concentrations in the cerebrospinal fluid with the motivational state of the patients | 36 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cerebrospinal fluid