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Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson's Disease: A Meta-Analysis.
Neuropsychol Rev. 2015 Dec; 25(4):439-54.NR

Abstract

Parkinson's disease (PD) is a common, degenerative disorder of the central nervous system. Individuals experience predominantly extrapyramidal symptoms including resting tremor, rigidity, bradykinesia, gait abnormalities, cognitive impairment, depression, and neurobehavioral concerns. Cognitive impairments associated with PD are diverse, including difficulty with attention, processing speed, executive functioning, memory recall, visuospatial functions, word-retrieval, and naming. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus internus (GPi) is FDA approved and has been shown to be effective in reducing motor symptoms of PD. Studies have found that stimulating STN and GPi are equally effective at improving motor symptoms and dyskinesias; however, there has been discrepancy as to whether the cognitive, behavioral, and mood symptoms are affected differently between the two targets. The present study used random-effects meta-analytic models along with a novel p-curve analytic procedure to compare the potential cognitive and emotional impairments associated with STN-DBS in the current literature to those associated with GPi-DBS. Forty-one articles were reviewed with an aggregated sample size of 1622 patients. Following STN-DBS, small declines were found in psychomotor speed, memory, attention, executive functions, and overall cognition; and moderate declines were found in both semantic and phonemic fluency. However, GPi-DBS resulted in fewer neurocognitive declines than STN-DBS (small declines in attention and small-moderate declines in verbal fluency). With regards to its effect on depression symptomatology, both GPi-DBS and STN-DBS resulted in lower levels of depressive symptoms post-surgery. From a neurocognitive standpoint, both GPi-DBS and STN-DBS produce subtle cognitive declines but appears to be relatively well tolerated.

Authors+Show Affiliations

Department of Psychology, University of Kentucky, 111C Kastle Hall, Lexington, KY, 40506, USA. Hannah.combs@uky.edu.Norton Neuroscience Institute, Louisville, KY, USA. bradley.folley@nortonhealthcare.org. Department of Neurosurgery, University of Kentucky, Lexington, KY, USA. bradley.folley@nortonhealthcare.org.Department of Psychology, University of Kentucky, 111C Kastle Hall, Lexington, KY, 40506, USA. dtrb85@gmail.com.Department of Psychology, University of Kentucky, 111C Kastle Hall, Lexington, KY, 40506, USA. segerstrom@uky.edu.Department of Neurology, University of Kentucky, Lexington, KY, USA. d.han@uky.edu.Department of Neurology, University of Kentucky, Lexington, KY, USA. Amelia.anderson@uky.edu.Department of Psychology, University of Kentucky, 111C Kastle Hall, Lexington, KY, 40506, USA. Brittany.walls@uky.edu.Department of Neurosurgery, University of Kentucky, Lexington, KY, USA. craigvanhorne@uky.edu.

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

26459361

Citation

Combs, Hannah L., et al. "Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson's Disease: a Meta-Analysis." Neuropsychology Review, vol. 25, no. 4, 2015, pp. 439-54.
Combs HL, Folley BS, Berry DT, et al. Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson's Disease: A Meta-Analysis. Neuropsychol Rev. 2015;25(4):439-54.
Combs, H. L., Folley, B. S., Berry, D. T., Segerstrom, S. C., Han, D. Y., Anderson-Mooney, A. J., Walls, B. D., & van Horne, C. (2015). Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson's Disease: A Meta-Analysis. Neuropsychology Review, 25(4), 439-54. https://doi.org/10.1007/s11065-015-9302-0
Combs HL, et al. Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson's Disease: a Meta-Analysis. Neuropsychol Rev. 2015;25(4):439-54. PubMed PMID: 26459361.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson's Disease: A Meta-Analysis. AU - Combs,Hannah L, AU - Folley,Bradley S, AU - Berry,David T R, AU - Segerstrom,Suzanne C, AU - Han,Dong Y, AU - Anderson-Mooney,Amelia J, AU - Walls,Brittany D, AU - van Horne,Craig, Y1 - 2015/10/12/ PY - 2015/07/01/received PY - 2015/10/05/accepted PY - 2015/10/14/entrez PY - 2015/10/16/pubmed PY - 2016/9/10/medline KW - Cognition KW - Deep brain stimulation KW - Pallidal KW - Parkinson’s disease KW - Subthalamic SP - 439 EP - 54 JF - Neuropsychology review JO - Neuropsychol Rev VL - 25 IS - 4 N2 - Parkinson's disease (PD) is a common, degenerative disorder of the central nervous system. Individuals experience predominantly extrapyramidal symptoms including resting tremor, rigidity, bradykinesia, gait abnormalities, cognitive impairment, depression, and neurobehavioral concerns. Cognitive impairments associated with PD are diverse, including difficulty with attention, processing speed, executive functioning, memory recall, visuospatial functions, word-retrieval, and naming. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus internus (GPi) is FDA approved and has been shown to be effective in reducing motor symptoms of PD. Studies have found that stimulating STN and GPi are equally effective at improving motor symptoms and dyskinesias; however, there has been discrepancy as to whether the cognitive, behavioral, and mood symptoms are affected differently between the two targets. The present study used random-effects meta-analytic models along with a novel p-curve analytic procedure to compare the potential cognitive and emotional impairments associated with STN-DBS in the current literature to those associated with GPi-DBS. Forty-one articles were reviewed with an aggregated sample size of 1622 patients. Following STN-DBS, small declines were found in psychomotor speed, memory, attention, executive functions, and overall cognition; and moderate declines were found in both semantic and phonemic fluency. However, GPi-DBS resulted in fewer neurocognitive declines than STN-DBS (small declines in attention and small-moderate declines in verbal fluency). With regards to its effect on depression symptomatology, both GPi-DBS and STN-DBS resulted in lower levels of depressive symptoms post-surgery. From a neurocognitive standpoint, both GPi-DBS and STN-DBS produce subtle cognitive declines but appears to be relatively well tolerated. SN - 1573-6660 UR - https://www.unboundmedicine.com/medline/citation/26459361/Cognition_and_Depression_Following_Deep_Brain_Stimulation_of_the_Subthalamic_Nucleus_and_Globus_Pallidus_Pars_Internus_in_Parkinson's_Disease:_A_Meta_Analysis_ L2 - https://doi.org/10.1007/s11065-015-9302-0 DB - PRIME DP - Unbound Medicine ER -