HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) All Versions of this Article: jnnp.2007.118786v1 79/7/789    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Google Scholar Articles by York, M K Articles by Jankovic, J PubMed PubMed Citation Articles by York, M K Articles by Jankovic, J

Cognitive declines following bilateral subthalamic nucleus deep brain stimulation for the treatment of Parkinson’s disease

¹ Baylor College of Medicine, Department of Neurology-The Parkinson’s Disease and Movement Disorders Clinic, Houston, Texas, USA
² Baylor College of Medicine, Department of Physical Medicine and Rehabilitation, Houston, Texas, USA
³ Baylor College of Medicine, Department of Neurosurgery, Houston, Texas, USA
⁴ The Methodist Hospital Neurological Institute, Houston, Texas, USA

Correspondence to:
Dr M K York, Baylor College of Medicine, Department of Neurology, 6501 Fannin, NB302, Houston, Texas 77030, USA; myork{at}bcm.edu

Methods: 23 patients who underwent DBS were compared with 28 medically treated patients with PD at baseline and at 6 months for neuropsychological measures. In addition to the group outcomes, we report reliable change indices (RCI) and a dementia caseness analysis.

Results: Patients who underwent DBS demonstrated a significant decline in verbal memory compared with the control group (p<0.003), and trends for decline on oral information processing, including verbal fluency, timed transcription and word naming. Patients who underwent DBS demonstrated declines in attention, set shifting and semantic fluency but these changes were similar to the rate of decline in the PD group. RCI indicated that patients who underwent DBS demonstrated clinically significant declines in verbal fluency (p<0.01) and inhibition of a dominant response (p<0.003), with trends for declines in set shifting (p<0.02) and verbal long term recall (p<0.08), indicative of frontostriatal dysfunction. Patients who underwent DBS did not demonstrate significant changes in depression, anxiety or psychological distress scores. The caseness analysis revealed that one of the patients who underwent DBS (4%) converted to dementia over 6 months compared with none of the PD controls.

Conclusions: Our findings demonstrated that patients who underwent DBS experienced declines in verbal recall and trends for declines in oral information processing 6 months following surgery, even when good motor outcome was achieved. Potential candidates should be counselled about the risk of mild frontostriatal cognitive declines following DBS to weigh the risks and benefits of surgery.