Tags

Type your tag names separated by a space and hit enter

Neuropsychological effects of bilateral deep brain stimulation of the subthalamic nucleus in Parkinson's disease.
Stereotact Funct Neurosurg. 2007; 85(2-3):113-20.SF

Abstract

OBJECTIVE

Although a relatively new technique, bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) for the treatment of advanced cases of Parkinson's disease (PD) shows considerable promise. While the benefits of the STN stimulation for the treatment of motor symptoms of PD are well established, some studies have reported negative neuropsychological outcomes, especially in elderly patients. The objective of the present study was to investigate the neuropsychological effects of bilateral STN-DBS in a small sample of elderly patients with PD.

METHODS

Six patients with PD (mean age 73.0 +/- 10.45 years) were assessed both before and approximately 6 months after DBS surgery in six neuropsychological domains. These domains included orientation, estimated IQ, attention/working memory, language, memory, and visual-spatial functioning. Additionally, depressive symptoms were assessed using the Geriatric Depression Scale. Daily doses of antiparkinsonian medications, in levodopa equivalents, were also compared pre- and postoperatively.

RESULTS

Antiparkinsonian medications were reduced postoperatively by a mean of 65%, from a mean levodopa equivalent dosage of 987 mg/day to 346 mg/day. Category fluency, a word generation task within the language domain, was the only test in which participants demonstrated a statistically significant decline in performance. Participants demonstrated a mean score decrease of 41% (p < 0.05) in category fluency.

CONCLUSIONS

The pathophysiology of the observed deficit remains ill defined. However, despite a small sample size, the study provides further evidence that bilateral STN-DBS in PD patients can be associated with negative neuropsychological outcome in word fluency, especially in elderly patients. Implications regarding patient selection for bilateral STN-DBS and recommendations for future research are further discussed.

Authors+Show Affiliations

Department of Neurological Surgery, University of Wisconsin Medical School, Madison, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17228177

Citation

Bordini, Brett J., et al. "Neuropsychological Effects of Bilateral Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease." Stereotactic and Functional Neurosurgery, vol. 85, no. 2-3, 2007, pp. 113-20.
Bordini BJ, Garg A, Gallagher CL, et al. Neuropsychological effects of bilateral deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Stereotact Funct Neurosurg. 2007;85(2-3):113-20.
Bordini, B. J., Garg, A., Gallagher, C. L., Bell, B., & Garell, P. C. (2007). Neuropsychological effects of bilateral deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Stereotactic and Functional Neurosurgery, 85(2-3), 113-20.
Bordini BJ, et al. Neuropsychological Effects of Bilateral Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease. Stereotact Funct Neurosurg. 2007;85(2-3):113-20. PubMed PMID: 17228177.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuropsychological effects of bilateral deep brain stimulation of the subthalamic nucleus in Parkinson's disease. AU - Bordini,Brett J, AU - Garg,Ankur, AU - Gallagher,Catherine L, AU - Bell,Brian, AU - Garell,P Charles, PY - 2007/01/12/received PY - 2007/1/18/pubmed PY - 2007/5/2/medline PY - 2007/1/18/entrez SP - 113 EP - 20 JF - Stereotactic and functional neurosurgery JO - Stereotact Funct Neurosurg VL - 85 IS - 2-3 N2 - OBJECTIVE: Although a relatively new technique, bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) for the treatment of advanced cases of Parkinson's disease (PD) shows considerable promise. While the benefits of the STN stimulation for the treatment of motor symptoms of PD are well established, some studies have reported negative neuropsychological outcomes, especially in elderly patients. The objective of the present study was to investigate the neuropsychological effects of bilateral STN-DBS in a small sample of elderly patients with PD. METHODS: Six patients with PD (mean age 73.0 +/- 10.45 years) were assessed both before and approximately 6 months after DBS surgery in six neuropsychological domains. These domains included orientation, estimated IQ, attention/working memory, language, memory, and visual-spatial functioning. Additionally, depressive symptoms were assessed using the Geriatric Depression Scale. Daily doses of antiparkinsonian medications, in levodopa equivalents, were also compared pre- and postoperatively. RESULTS: Antiparkinsonian medications were reduced postoperatively by a mean of 65%, from a mean levodopa equivalent dosage of 987 mg/day to 346 mg/day. Category fluency, a word generation task within the language domain, was the only test in which participants demonstrated a statistically significant decline in performance. Participants demonstrated a mean score decrease of 41% (p < 0.05) in category fluency. CONCLUSIONS: The pathophysiology of the observed deficit remains ill defined. However, despite a small sample size, the study provides further evidence that bilateral STN-DBS in PD patients can be associated with negative neuropsychological outcome in word fluency, especially in elderly patients. Implications regarding patient selection for bilateral STN-DBS and recommendations for future research are further discussed. SN - 1011-6125 UR - https://www.unboundmedicine.com/medline/citation/17228177/Neuropsychological_effects_of_bilateral_deep_brain_stimulation_of_the_subthalamic_nucleus_in_Parkinson's_disease_ L2 - https://www.karger.com?DOI=10.1159/000098526 DB - PRIME DP - Unbound Medicine ER -