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Neuropsychological performance following staged bilateral pallidal or subthalamic nucleus deep brain stimulation for Parkinson's disease.
J Int Neuropsychol Soc. 2007 Jan; 13(1):68-79.JI

Abstract

Deep brain stimulation (DBS) has the potential to significantly reduce motor symptoms in advanced Parkinson's disease (PD). Controversy remains about non-motor effects of DBS and the relative advantages of treatment at two brain targets, the globus pallidus internus (GPi) and the subthalamic nucleus (STN). We investigated effects of DBS on neuropsychological functioning in 42 patients with advanced PD randomly assigned to receive staged bilateral DBS surgery of either the GPi or STN. Patients underwent neuropsychological assessment prior to and 6 months after unilateral surgery. Twenty-nine subsequently underwent surgery to the contralateral side and completed a second follow-up neuropsychological evaluation 15 months later. Unilateral treatment resulted in small but statistically significant reductions in performance on several measures, including verbal fluency and working memory. A similar pattern was observed after bilateral treatment. Reductions in verbal associative fluency were significant only after left-sided treatment. There were few significant differences related to treatment at the two surgical targets. Supplementary analyses suggested that decrements in select neuropsychological domains following DBS are unrelated to age or post-surgical reduction in dopaminergic medication dose. Findings are discussed with reference to possible causes of neuropsychological decline and the need for further controlled studies of specific neuropsychological effects of DBS.

Authors+Show Affiliations

Mental Health Service, Veterans Affairs Medical Center, San Francisco, California 94121, USA. Johannes.Rothlind@Med.VA.GovNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17166305

Citation

Rothlind, Johannes C., et al. "Neuropsychological Performance Following Staged Bilateral Pallidal or Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease." Journal of the International Neuropsychological Society : JINS, vol. 13, no. 1, 2007, pp. 68-79.
Rothlind JC, Cockshott RW, Starr PA, et al. Neuropsychological performance following staged bilateral pallidal or subthalamic nucleus deep brain stimulation for Parkinson's disease. J Int Neuropsychol Soc. 2007;13(1):68-79.
Rothlind, J. C., Cockshott, R. W., Starr, P. A., & Marks, W. J. (2007). Neuropsychological performance following staged bilateral pallidal or subthalamic nucleus deep brain stimulation for Parkinson's disease. Journal of the International Neuropsychological Society : JINS, 13(1), 68-79.
Rothlind JC, et al. Neuropsychological Performance Following Staged Bilateral Pallidal or Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease. J Int Neuropsychol Soc. 2007;13(1):68-79. PubMed PMID: 17166305.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuropsychological performance following staged bilateral pallidal or subthalamic nucleus deep brain stimulation for Parkinson's disease. AU - Rothlind,Johannes C, AU - Cockshott,Randall W, AU - Starr,Philip A, AU - Marks,William J,Jr PY - 2005/09/28/received PY - 2006/07/10/revised PY - 2006/07/13/accepted PY - 2006/12/15/pubmed PY - 2007/3/14/medline PY - 2006/12/15/entrez SP - 68 EP - 79 JF - Journal of the International Neuropsychological Society : JINS JO - J Int Neuropsychol Soc VL - 13 IS - 1 N2 - Deep brain stimulation (DBS) has the potential to significantly reduce motor symptoms in advanced Parkinson's disease (PD). Controversy remains about non-motor effects of DBS and the relative advantages of treatment at two brain targets, the globus pallidus internus (GPi) and the subthalamic nucleus (STN). We investigated effects of DBS on neuropsychological functioning in 42 patients with advanced PD randomly assigned to receive staged bilateral DBS surgery of either the GPi or STN. Patients underwent neuropsychological assessment prior to and 6 months after unilateral surgery. Twenty-nine subsequently underwent surgery to the contralateral side and completed a second follow-up neuropsychological evaluation 15 months later. Unilateral treatment resulted in small but statistically significant reductions in performance on several measures, including verbal fluency and working memory. A similar pattern was observed after bilateral treatment. Reductions in verbal associative fluency were significant only after left-sided treatment. There were few significant differences related to treatment at the two surgical targets. Supplementary analyses suggested that decrements in select neuropsychological domains following DBS are unrelated to age or post-surgical reduction in dopaminergic medication dose. Findings are discussed with reference to possible causes of neuropsychological decline and the need for further controlled studies of specific neuropsychological effects of DBS. SN - 1355-6177 UR - https://www.unboundmedicine.com/medline/citation/17166305/Neuropsychological_performance_following_staged_bilateral_pallidal_or_subthalamic_nucleus_deep_brain_stimulation_for_Parkinson's_disease_ L2 - https://www.cambridge.org/core/product/identifier/S1355617707070105/type/journal_article DB - PRIME DP - Unbound Medicine ER -