Cognitive functioning after pallidotomy for refractory Parkinson’s disease
- Kenneth Perrinea,
- Michael Dogalib,
- Enrico Fazzinia,
- Djorje Sterioa,
- Edwin Kolodnya,
- David Eidelbergc,
- Orrin Devinskya,
- Aleksandar Berica
- aDepartment of Neurology, NYU School of Medicine and Hospital for Joint Diseases, New York, USA, bDepartment of Neurosurgery, University of California, Irvine, CA, USA, cDepartment of Neurology, Cornell University Medical Center and North Shore University Hospital, USA
- Dr Kenneth Perrine, Department of Neurology, Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA. Telephone 001 212 598 6558; fax 001 212 598 6169.
- Received 22 January 1997
- Revised 5 January 1998
- Accepted 13 January 1998
Abstract
BACKGROUND Earlier approaches to pallidotomy for refractory Parkinson’s disease had significant complication rates. More recent approaches show fewer complications, but the effect of pallidotomy on cognition is unclear. The current study was conducted to examine the neuropsychological effects of unilateral pallidotomy.
METHODS Neuropsychological testing was performed on patients with medically refractory, predominantly unilateral Parkinson’s disease at baseline and after unilateral ventral pallidotomy (n=28) or after an equivalent period without surgery in control patients (n=10).
RESULTS Pallidotomy patients showed no significant changes from baseline to retesting relative to the control group for any measure. Across all of the tests administered, only five of the surgery patients showed a significant decline, and of these five none declined on more than one test. Depression did not relate to preoperative or postoperative cognition. The pallidotomy group showed a significant improvement in motor functioning and activities of daily living whereas the control group did not. These measures were not associated with the neuropsychological test scores at baseline or retest.
CONCLUSIONS Stereotactic unilateral ventral pallidotomy does not seem to produce dramatic cognitive declines in most patients.
