PAPER

Neuropsychological and quality of life outcomes 12 months after unilateral thalamic stimulation for essential tremor

J A Fields¹, A I Tröster^1,2, S P Woods¹, C I Higginson³, S B Wilkinson⁴, K E Lyons⁵, W C Koller⁵ and R Pahwa⁶

¹ Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA
² Department of Neurological Surgery, University of Washington School of Medicine
³ Center for Neuroscience, University of California, Davis, USA
⁴ Department of Neurosurgery, University of Kansas Medical Center, Kansas City, USA
⁵ Department of Neurology, University of Miami School of Medicine, Miami, USA
⁶ Department of Neurology, University of Kansas Medical Center

Correspondence to:
Correspondence to:
Dr A I Tröster, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific Street, BB 1529, Box 356560, Seattle, WA 98195–6560, USA;
atroster{at}u.washington.edu

Objectives: To evaluate the one year cognitive, mood state, and quality of life (QoL) outcomes of unilateral thalamic deep brain stimulation (DBS) for essential tremor (ET).

Methods: 40 patients diagnosed with ET completed comprehensive neuropsychological assessments about one month before and three and 12 months after DBS electrode implantation. Data were subjected to multivariate analyses, and significant results were further analysed using univariate techniques.

Results: Analyses revealed statistically significant improvements on a cognitive screening measure and in aspects of fine visuomotor and visuoperceptual functions, verbal memory, mood state, and QoL. No group-wise declines in cognition were observed, but more patients showed declines than improvements on language and visual memory tests. Semantic verbal fluency declined significantly in four (10%) of the patients. In these four patients, diminished lexical verbal fluency was present at baseline.

Conclusion: Cognitive, mood, and QoL outcomes after one year of DBS for ET are favourable; there were no overall deleterious effects on cognition, and DBS was accompanied by a significant reduction in anxiety and improvements in quality of life. However, preoperative verbal fluency diminution may predispose to further fluency declines after DBS.

Keywords: neuropsychology; quality of life; essential tremor; deep brain stimulation

Abbreviations: ET, essential tremor; DBS, deep brain stimulation; QoL, quality of life; PD, Parkinson’s disease

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• Diamond, A, Jankovic, J (2005). The effect of deep brain stimulation on quality of life in movement disorders. J. Neurol. Neurosurg. Psychiatry 76: 1188-1193 [Abstract] [Full Text]