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Neuropsychological Sequelae of Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease: A Critical Review

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Abstract

Neuropsychologists are increasingly involved in surgical candidacy evaluations and postoperative neurobehavioral assessments of patients with movement disorders, most notably those with disease (PD). We review here the initial studies regarding neuropsychological outcomes of deep brain stimulation (DBS) within the subthalamic nucleus (STN) for treatment of PD. Overall, these initial investigations provide preliminary support for the cognitive and neurobehavioral safety of STN DBS. Improvements in self-reported symptoms of depression and diminished verbal fluency were the most common findings, whereas changes in global cognitive abilities, memory, attention, and frontal/executive functions were inconsistent and most often described as nominal and/or transient. The generalizability of this literature is hindered by several methodological limitations, including small samples and the absence of appropriate control participants. The clinical and theoretical implications of these initial studies are highlighted and recommendations are offered to guide future research.

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REFERENCES

  • Adams, R. D., Victor, M., and Ropper, A. H. (1997). Principles of Neurology, 6th edn., McGraw-Hill, New York.

    Google Scholar 

  • Afifi, A. K., and Bergman, R. A. (1998). Functional Neuroanatomy Text and Atlas, McGraw-Hill, New York.

    Google Scholar 

  • Alegret, M., Junqué, C., Valldeoriola, F., Vendrell, P., Pilleri, M., Rumia, J., and Tolosa, E. (2001). Effects of bilateral subthalamic stimulation on cognitive function in Parkinson disease. Archives of Neurology 58: 1223–1227.

    Google Scholar 

  • Alexander, G. E., DeLong, M. R., and Strick, P. L. (1986). Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neuroscience 9: 357–381.

    Google Scholar 

  • Alvarez, L., Macias, R., Guridi, J., Lopez, G., Alvarez, E., Maragoto, C., Teijeiro, J., Torres, A., Pavon, N., Rodriguez-Oroz, M. C., Ochoa, L., Hetherington, H., Juncos, J., DeLong, M. R., and Obeso, J. A. (2001). Dorsal subthalamotomy for Parkinson's disease. Movement Disorders 16: 72–78.

    Google Scholar 

  • Andy, O. J., Jurko, M. F., and Sias, F. R. (1963). Subthalamotomy in treatment of parkinsonian tremor. Journal of Neurosurgery 20: 861–871.

    Google Scholar 

  • Ardouin, C., Pillon, B., Peiffer, E., Bejjani, P., Limousin, P., Damier, P., Arnulf, L., Benabid, A. L., Agid, Y., and Pollak, P. (1999). Bilateral subthalamic or pallidal stimulation for Parkinson's disease affects neither memory nor executive functions: A consecutive series of 62 patients. Annals of Neurology 46: 217–223.

    Google Scholar 

  • Ashby, P., Kim, Y. J., Kumar, R., Lang, A. E., and Lozano, A. M. (1999). Neurophysiological effects of stimulation through electrodes in the human subthalamic nucleus. Brain 122: 1919–1931.

    Google Scholar 

  • Baunez, C., Nieoullon, A., and Amalric, M. (1995). In a rat model of parkinsonism, lesions of the subthalamic nucleus reverse increases of reaction time but induce a dramatic premature responding deficit. Journal of Neuroscience 15: 6531–6541.

    Google Scholar 

  • Baunez, C., and Robbins, T. W. (1997). Bilateral lesions of the subthalamic nucleus induce multiple deficits in an attentional task in rats. European Journal of Neuroscience 9: 2086–2099.

    Google Scholar 

  • Baunez, C., and Robbins, T. W. (1999). Effects of dopamine depletion of the dorsal striatum and further interaction with subthalamic nucleus lesions in an attentional task in the rat. Neuroscience 92: 1343–1356.

    Google Scholar 

  • Bejjani, B. P., Damier, P., Arnulf, L., Thivard, L., Bonnet, A. M., Dormont, D., Cornu, P., Pidoux, B., Samson, Y., and Agid, Y. (1999). Transient acute depression induced by high-frequency deepbrain stimulation. New England Journal of Medicine 340: 1476–1480.

    Google Scholar 

  • Benabid, A. L., Pollak, P., Gross, C., Hoffmann, D., Benazzouz, A., Gao, D. M., Laurent, A., Gentil, M., and Perret, J. (1994). Acute and long-term effects of subthalamic nucleus stimulation in Parkinson's disease. Stereotactic and Functional Neurosurgery 62: 76–84.

    Google Scholar 

  • Benazzouz, A., and Hallett, M. (2000). Mechanism of action of deep brain stimulation. Neurology 55(Suppl. 6): 13–16.

    Google Scholar 

  • Brody, A. L., Barsom, M. W., Bota, R. G., and Saxena, S. (2001). Prefrontal-subcortical and limbic circuit mediation of major depressive disorder. Seminars in Clinical Neuropsychiatry 6: 102–112.

    Google Scholar 

  • Burchiel, K. J., Anderson, V. C., Favre, J., and Hammerstad, J. P. (1999). Comparison of pallidal and subthalamic nucleus deep brain stimulation for advanced Parkinson's disease: Results of a randomized, blinded pilot study. Neurosurgery 45: 1375–1384.

    Google Scholar 

  • Campbell, D. T., and Stanley, J. C. (1963). Experimental and Quasi-Experimental Designs for Research, Houghton Mifflin, Boston, MA.

    Google Scholar 

  • Ceballos-Baumann, A. O., Boecker, H., Bartenstein, P., von Falkenhayn, I., Riescher, H., Conrad, B., Moringlane, J. R., and Alesch, F. (1999). A positron emission tomographic study of subthalamic nucleus stimulation in Parkinson disease: Enhanced movement-related activity of motor-association cortex and decreased motor cortex resting activity. Archives of Neurology 56: 997–1003.

    Google Scholar 

  • Cummings, J. L. (1993). Frontal-subcortical circuits and human behavior. Archives of Neurology 50: 873–880.

    Google Scholar 

  • Defer, G. L., Widner, H., Marie, R. M., Remy, P., and Levivier, M. (2000). Core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT-PD). Movement Disorders 14: 572–584.

    Google Scholar 

  • Diederich, N. J., Alesch, F., and Goetz, C. G. (2000). Visual hallucinations induced by deep brain stimulation in Parkinson's disease. Clinical Neuropharmacology 23: 287–289.

    Google Scholar 

  • Dodel, R. C., Spottke, E. A., and Oertel, W. H. (2000). Lebensqualität and Kosten neurochirurgischer Verfahren in der Behandlung der Parkinson-Erkrankung. Aktuelle Neurologie 27(Suppl. 1): 61–69.

    Google Scholar 

  • Duff, K., Westervelt, H. J., McCaffrey, R. J., and Haase, R. F. (2001). Practice effects, test-retest stability, and dual baseline assessments with the CaliforniaVerbal Learning Test in an HIV sample. Archives of Clinical Neuropsychology 16: 461–467.

    Google Scholar 

  • Dujardin, K., Defebvre, L., Krystkowiak, P., Blond, S., and Destee, A. (2001). Influence of chronic bilateral stimulation of the subthalamic nucleus on cognitive function in Parkinson's disease. Journal of Neurology 248: 603–611.

    Google Scholar 

  • Fahn, S., Elton, R. L., and Members of the UPDRS Development Committee (1987). The Unified Parkinson's Disease Rating Scale. In: Fahn, S., Marden, S. D., Calne, D. B., and Goldstein, M. (eds.), Recent Developments in Parkinson's Disease, Vol. 2, Macmillan Healthcare, Florham Park, NJ, pp. 153–163.

    Google Scholar 

  • Fields, J. A., and Tröster, A. I. (2000). Cognitive outcomes after deep brain stimulation for Parkinson's disease: A review of initial studies and recommendations for future research. Brain and Cognition 42: 268–293.

    Google Scholar 

  • Fields, J. A., Tröster, A. I., Wilkinson, S. B., Pahwa, R., and Koller, W. C. (1999). Cognitive outcome following staged bilateral pallidal stimulation for the treatment of Parkinson's disease. Clinical Neurology and Neurosurgery 101: 182–188.

    Google Scholar 

  • Folstein, M. F., Folstein, S. E., and McHugh, P. R. (1975). Mini mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12: 189–198.

    Google Scholar 

  • Funkieweiz, A., Caputo, E., Ardouin, C., Krack, P., Fraix, V., Benabid, A. L., and Pollak, P. (2001). Behavioral and mood changes associated with bilateral stimulation of the subthalamic nucleus: A consecutive series of 98 Parkinsonian patients [abstract]. Neurology 56(Suppl. 3): 274.

    Google Scholar 

  • Gaillard, W. D., Hertz-Pannier, L., Mott, S. H., Barnett, A. S., LeBihan, D., and Theodore, W. H. (2000). Functional anatomy of cognitive development: fMRI of verbal fluency in children and adults. Neurology 54: 180–185.

    Google Scholar 

  • Gerschlager, W., Alesch, F., Cunnington, R., Deecke, L., Dirnberger, G., Endl, W., Lindinger, G., and Lang, W. (1999). Bilateral subthalamic nucleus stimulation improves frontal cortex function in Parkinson's disease. An electrophysiological study of the contingent negative variation. Brain 122: 2365–2373.

    Google Scholar 

  • Gerschlager, W., Bloem, B. R., Alesch, F., Lang, W., Deecke, L., and Cunnington, R. (2001). Bilateral subthalamic nucleus stimulation does not improve prolonged P300 latencies in Parkinson's disease. Journal of Neurology 248: 285–289.

    Google Scholar 

  • Gildenberg, P. L. (1995). Management of movement disorders. An overview. Neurosurgery Clinics of North America 6: 43–53.

    Google Scholar 

  • Gray, A., McNamara, I., Aziz, T., Gregory, R., Bain, P., Wilson, J., and Scott, R. (2002). Quality of life outcomes following surgical treatment of Parkinson's disease. Movement Disorders 17: 68–75.

    Google Scholar 

  • Hariz, M. I., and Fodstad, H. (1999). Do microelectrode techniques increase accuracy or decrease risks in pallidotomy and deep brain stimulation? A critical review of the literature. Stereotactic and Functional Neurosurgery 72: 157–169.

    Google Scholar 

  • Hariz, M. I., Johansson, F., Shamsgovara, P., Johansson, E., Hariz, G. M., and Fagerlund, M. (2000). Bilateral subthalamic nucleus stimulation in a Parkinsonian patient with preoperative deficits in speech and cognition: Persistent improvement in mobility but increased dependency: A case study. Movement Disorders 15: 136–139.

    Google Scholar 

  • Heaton, R. K., Chelune, G. J., Talley, J. L., Kay, G. G., and Curtiss, G. (1993). Wisconsin Card Sorting Test manual-revised and expanded, Psychological Assessment Resources, Odessa, FL.

    Google Scholar 

  • Henderson, J. M., and Dunnett, S. B. (1998). Targeting the subthalamic nucleus in the treatment of Parkinson's disease. Brain Research Bulletin 46: 467–474.

    Google Scholar 

  • Henderson, J. M., O'Sullivan, D. J., Pell, M., Fung, V. S. C., Hely, M. A., Morris, J. G. L., and Halliday, G. M. (2001). Lesion of thalamic centromedian-parafascicular complex after chronic deep brain stimulation. Neurology 56: 1576–1579.

    Google Scholar 

  • Higginson, C. I., Fields, J. A., Koller, W. C., and Tröster, A. I. (2001a). Questionnaire assessment potentially overestimates anxiety in Parkinson's disease. Journal of Clinical Psychology in Medical Settings 8: 95–99.

    Google Scholar 

  • Higginson, C. I., Fields, J. A., and Tröster, A. I. (2001b). Which symptoms of anxiety diminish after surgical interventions for Parkinson disease? Neuropsychiatry, Neuropsychology, and Behavioral Neurology 14: 117–121.

    Google Scholar 

  • Jacobson, N. S., Roberts, L. J., Berns, S. B., and McGlinchey, J. B. (1999). Methods for defining and determining clinical significance of treatment effects: Description, application, and alternatives. Journal of Consulting and Clinical Psychology 67: 300–307.

    Google Scholar 

  • Jacobson, N. S., and Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 59: 12–19.

    Google Scholar 

  • Jahanshahi, M., Ardouin, C. M. A., Brown, R. G., Rothwell, J. C., Obeso, J., Albanese, A., Rodriguez-Oroz, M. C., Moro, E., Benabid, A. L., Pollak, P., and Limousin-Dowsey, P. (2000). The impact of deep brain stimulation on executive function in Parkinson's disease. Brain 123: 1142–1154.

    Google Scholar 

  • Jech, R., Urgosik, D., Tintera, J., Nebuzelsky, A., Krasensky, J., Liscak, R., Roth, J., and Ruzicka, E. (2001). Functional magnetic resonance imaging during deep brain stimulation: A pilot study in four patients with Parkinson's disease. Movement Disorders 16: 1126–1132.

    Google Scholar 

  • Joel, D. (2001). Open interconnected model of basal gangliathalamocortical circuitry and its relevance to the clinical syndrome of Huntington's disease. Movement Disorders 16: 407–423.

    Google Scholar 

  • Krack, P., Kumar, R., Ardouin, C., Limousin-Dowsey, P., McVicker, J. M., Benabid, A. L., and Pollak, P. (2001). Mirthful laughter induced by subthalamic nucleus stimulation. Movement Disorders 16: 867–875.

    Google Scholar 

  • Krack, P., Pollak, P., Limousin, P., Hoffman, D., Xie, J., Benazzouz, A., and Benabid, A. L. (1998). Subthalamic nucleus or internal pallidal stimulation in young onset Parkinson's disease. Brain 121: 451–457.

    Google Scholar 

  • Kulisevsky, J. (2000). Role of dopamine in learning and memory: Implications for the treatment of cognitive dysfunction in patients with Parkinson's disease. Drugs and Aging 16: 365–379.

    Google Scholar 

  • Kulisevsky, J., Berthier, M. L., Gironell, A., Gironell, A., Pascual-Sedano, B., Molet, J., and Pares, P. (2001). Secondary mania following subthalamic nucleus deep brain stimulation for the treatment of Parkinson's disease [abstract]. Neurology 56(Suppl. 3): 49.

    Google Scholar 

  • Langfitt, J. T., Wood, B. L., Brand, K. L., Brand, J., and Erba, G. (1999). Family interactions as targets for intervention to improve social adjustment after epilepsy surgery. Epilepsia 40: 735–744.

    Google Scholar 

  • Levesque, M. F., Taylor, S., Rogers, R., Le, M. T., and Swope, D. (1999). Subthalamic stimulation in Parkinson's disease. Preliminary results. Stereotactic and Functional Neurosurgery 72: 170–173.

    Google Scholar 

  • Limousin, P., Greene, J., Pollak, P., Rothwell, J., Benabid, A. L., and Frackowiak, R. (1997). Changes in cerebral activity pattern due to subthalamic nucleus or internal pallidum stimulation in Parkinson's disease. Annals of Neurology 42: 283–291.

    Google Scholar 

  • Limousin, P., Krack, P., Pollak, P., Benazzouz, A., Ardouin, C., Hoffmann, D., and Benabid, A. L. (1998). Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease. New England Journal of Medicine 339A: 1105–1111.

    Google Scholar 

  • Limousin, P., Pollak, P., Benazzouz, A., Hoffmann, D., Le Bas, J. F., Broussolle, E., Perret, J. E., and Benabid, A. L. (1995). Effect of parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation. Lancet 345: 91–95.

    Google Scholar 

  • Lopiano, L., Rizzone, M., Bergamasco, B., Tavella, A., Torre, E., Perozzo, P., Valentini, M. C., and Lanotte, M. (2001). Deep brain stimulation of the subthalamic nucleus: Clinical effectiveness and safety. Neurology 56: 552–554.

    Google Scholar 

  • Martinez-Martin, P., Valldeoriola, F., Tolosa, E., Pilleri, M., Molinuevo, J. L., Rumia, J., and Ferrer, E. (2002). Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson's disease. Movement Disorders. 17: 372–377.

    Google Scholar 

  • Mattis, S. (1988). Dementia Rating Scale: Professional Manual, Psychological Assessment Resources, Odessa, FL.

    Google Scholar 

  • Maurice, N., Deniau, J. M., Menetrey, A., Glowinski, J., and Thierry, A. M. (1998). Prefrontal cortex-basal ganglia circuits in the rat: Involvement of ventral pallidum and subthalamic nucleus. Synapse 29: 363–370.

    Google Scholar 

  • McCarter, R. J., Walton, N. H., Rowan, A. F., Gill, S. S., and Palomo, M. (2000). Cognitive functioning after subthalamic nucleotomy for refractory Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry 69: 60–66.

    Google Scholar 

  • Middleton, F. A., and Strick, P. L. (2000). Basal ganglia output and cognition: Evidence from anatomical, behavioral, and clinical studies. Brain and Cognition 42: 183–200.

    Google Scholar 

  • Middleton, F. A., and Strick, P. L. (2001). Revised neuroanatomy of frontal-subcortical circuits. In Lichter, D. G., and Cummings, J. L. (eds.), Frontal-Subcortical Circuits in Psychiatric and Neurological Disorders, Guilford Press, New York, pp. 44–58.

    Google Scholar 

  • Morietti, R., Torre, P., Antonello, R. M., Capus, L., Gioulis, M., Marsala, S. Z., Cazzato, G., and Bava, A. (2001). Effects on cognitive abilities following subthalamic nucleus stimulation in Parkinson's disease [letter to the editor]. European Journal of Neurology 8: 725–731.

    Google Scholar 

  • Moro, E., Scerrati, M., Romito, L. M. A., Roselli, R., Tonali, P., and Albanese, A. (1999). Chronic subthalamic nucleus stimulation reduces medication requirements in Parkinson's disease. Neurology 53: 85–90.

    Google Scholar 

  • Morrison, C. E., Borod, J. C., Brin, M. F., Raskin, S. A., Germano, I. M., Weisz, D. J., and Olanow, C. W. (2000). A program for neuropsychological investigation of deep brain stimulation (PNIDBS) in movement disorder patients: Development, feasibility, and preliminary data. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 13: 204–219.

    Google Scholar 

  • Morrison, C., Borod, J., Perrine, K., Beric, A., Brin, M., Rezai, A., Kelly, P., Stereo, G., Zgaljardic, D., Germano, I., Weisz, D., Gracies, J. M., and Olanow, C. W. (2001). Cognition and subthalamic nucleus (STN) stimulation in Parkinson's disease (PD) [abstract]. Journal of the International Neuropsychological Society 7: 129.

    Google Scholar 

  • Mundinger, F. (1968). Results of 500 subthalamotomies in the region of the zona incerta. In Gillingham, F. J., and Donaldson, I. M. L. (eds.), Third Symposium on Parkinson's Disease, E&S Livingstone, Edinburgh, England, pp. 261–265.

    Google Scholar 

  • Obeso, J. A., Rodriguez, M. C., Gorospe, A., Guridi, J., Alvarez, L., and Macias, R. (1997). Surgical treatment of Parkinson's disease. Baillieres Clinical Neurology 6: 125–145.

    Google Scholar 

  • Ogles, B. M., Lunnen, K. M., and Bonesteel, K. (2001). Clinical significance: History, application, and current practice. Clinical Psychology Review 21: 421–446.

    Google Scholar 

  • Olanow, C. W., Watts, R. L., and Koller, W. C. (2001). An algorithm (decision tree) for the management of Parkinson's disease (2001): Treatment guidelines. Neurology 56(Suppl. 5): 1–8.

    Google Scholar 

  • Parent, A., Levesque, M., and Parent, M. (2001). A re-evaluation of the current model of the basal ganglia. Parkinsonism and Related Disorders 7: 193–198.

    Google Scholar 

  • Percheron, G., and Filion, M. (1991). Parallel processing in the basal ganglia: Up to a point. Trends in Neuroscience 14: 55–59.

    Google Scholar 

  • Perozzo, P., Rizzone, M., Bergamasco, B., Castelli, L., Lanotte, M., Tavella, A., Torre, E., and Lopiano, L. (2001a). Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: Comparison of pre-and post-operative neuropsychological evaluation. Journal of the Neurological Sciences 192: 9–15.

    Google Scholar 

  • Perozzo, P., Rizzone, M., Bergamasco, B., Castelli, L., Lanotte, M., Tavella, A., Torre, E., and Lopiano, L. (2001b). Deep brain stimulation of the subthalamic nucleus: Behavioral modifications and familiar relations. Neurological Sciences 22: 81–82.

    Google Scholar 

  • Peterson, R. C., Stevens, J. C., Ganguli, M., Tangalos, E. G., Cummings, J. L., and DeKosky, S. T. (2001). Practice parameter: Early detection of dementia: Mild cognitive impairment (an evidencebased review). Neurology 56: 1133–1142. Report of the Quality Standards Subcommittee of the American Academy of Neurology.

    Google Scholar 

  • Pillon, B., Ardouin, C., Damier, P., Krack, P., Houeto, J. L., Klinger, H., Bonnet, A. M., Pollak, P., Benabid, A. L., and Agid, Y. (2000). Neuropsychological changes between “off” and “on” STN or GPi stimulation in Parkinson's disease. Neurology 55: 411–418.

    Google Scholar 

  • Pollak, P., Benabid, A. L., Gross, C., Gao, D. M., Laurent, A., Benazzouz, A., Hoffmann, D., Gentil, M., and Perret, J. (1993). Effects of the stimulation of the subthalamic nucleus in Parkinson disease. Revue Neurologique 149: 175–176.

    Google Scholar 

  • Rizzone, M., Lanotte, M., Bergamasco, B., Tavella, A., Torre, E., Faccani, G., Melcarne, A., and Lopiano, L. (2001). Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: Effects of variation in stimulation parameters. Journal of Neurology, Neurosurgery, and Psychiatry 71: 215–219.

    Google Scholar 

  • Rodriguez-Oroz, M. C., Gorospe, A., Guridi, J., Ramos, E., Linazasoro, G., Rodriguez-Palmero, M., and Obeso, J. A. (2000). Bilateral deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Neurology 55(Suppl. 6): 45–51.

    Google Scholar 

  • Saint-Cyr, J. A., and Tr´epanier, L. L. (2000). Neuropsychologic assessment of patients for movement disorder surgery. Movement Disorders 15: 771–783.

    Google Scholar 

  • Saint-Cyr, J. A., Trépanier, L. L., Kumar, R., Lozano, A. M., and Lang, A. E. (2000). Neuropsychological consequences of chronic bilateral stimulation of the subthalamic nucleus in Parkinson's disease. Brain 123: 2091–2108.

    Google Scholar 

  • Satz, P. (1993). Brain reserve capacity on symptom onset after brain injury: A formulation and review of evidence for threshold theory. Neuropsychology 7: 273–295.

    Google Scholar 

  • Saxena, S., Brody, A. L., Schwartz, J. M., and Baxter, L. R. (1998). Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder. British Journal of Psychiatry 173(Suppl. 35): 26–37.

    Google Scholar 

  • Schmand, B., de Bie, R. M., Koning-Haanstra, M., de Smet, J. S., Speelman, J. D., and van Zomeren, A. H. (2000). Unilateral pallidotomy in PD: A controlled study of cognitive and behavioral effects. Neurology 54: 1058–1064. The Netherlands Pallidotomy Study (NEPAS) group.

    Google Scholar 

  • Spiegel, E. A., Wycis, H. T., Szekely, E. G., Adams, J., Flanagan, M., and Baird, H. W. (1963). Campotomy in various extrapyramidal disorders. Journal of Neurosurgery 20: 870–874.

    Google Scholar 

  • Sterio, D., Rezai, A., Mogilner, A., Zonenshayn, M., Gracies, J. M., Kathirithamby, K., and Beric, A. (2002). Neurophysiological modulation of the subthalamic nucleus by pallidal stimulation in Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry 72: 325–328.

    Google Scholar 

  • Stern,Y., Albert, S., Tang, M. X., and Tsai, W. Y. (1999). Rate of memory decline in AD is related to education and occupation: Cognitive reserve? Neurology 53: 1942–1947.

    Google Scholar 

  • Straits-Tröster, K., Fields, J. A., Wilkinson, S. B., Pahwa, R., Lyons, K. E., Koller, W. C., and Tröster, A. I. (2000). Health-related quality of life in Parkinson's disease after pallidotomy and deep brain stimulation. Brain and Cognition 42: 399–416.

    Google Scholar 

  • Tabachnick, B. G., and Fidell, L. S. (1996). Using Multivariate Statistics, 3rd edn., HaperCollins, New York.

    Google Scholar 

  • Temkin, N. R., Heaton, R. K., Grant, I., and Dikmen, S. S. (1999). Detecting significant change in neuropsychological test performance: A comparison of four models. Journal of the International Neuropsychological Society 5: 357–369.

    Google Scholar 

  • Trépanier, L. L., Kumar, R., Lozano, A. M., Lang, A. E., and Saint-Cyr, J. A. (2000). Neuropsychological outcome of GPi pallidotomy and GPi or STN deep brain stimulation in Parkinson's disease. Brain and Cognition 42: 324–347.

    Google Scholar 

  • Tröster, A. I. (2000a). Clinical neuropsychology, functional neurosurgery, and restorative neurology in the next millennium: Beyond secondary outcome measures. Brain and Cognition 42: 117–119.

    Google Scholar 

  • Tröster, A. I. (2000b). Introduction to neurobehavioral issues in the neurosurgical treatment of movement disorders: Basic issues, thalamotomy, and nonablative treatments. Brain and Cognition 42: 173–182.

    Google Scholar 

  • Tröster, A. I., and Fields, J. A. (in press). The role of neuropsychological evaluation in the neurosurgical treatment of movement disorders. In Tarsy, D., Vitek, J., and Lozano, A. (eds.), Surgical Treatment of Parkinson's Disease and Other Movement Disorders, Humana Press, Totowa, NJ.

  • Tröster, A. I., Fields, J. A., and Koller, W. C. (2000). Parkinson's disease and parkinsonism. In Coffey, C. E., and Cummings, J. L. (eds.), The American Psychiatric Press Textbook of Geriatric Neuropsychiatry, 2nd edn., American Psychiatric Press, Washington, DC, pp. 559–600.

    Google Scholar 

  • Tröster, A. I., Fields, J. A., Pahwa, R., Wilkinson, S. B., Strait-Tröster, K. A., Lyons, K., Kieltyka, J., and Koller, W. C. (1999). Neuropsychological and quality of life outcome after thalamic stimulation for essential tremor. Neurology 53: 1774–1780.

    Google Scholar 

  • Tröster, A. I., Fields, J. A., Wilkinson, S. B., Busenbark, K., Miyawaki, E., Overman, J., Pahwa, R., and Koller, W. C. (1998). Neuropsychological functioning before and after unilateral thalamic stimulating electrode implantation in Parkinson's disease. Neurosurgical Focus 2: 1–6.

    Google Scholar 

  • Tröster, A. I., Fields, J. A., Wilkinson, S. B., Pahwa, R., Miyawaki, E., Lyons, K. E., and Koller, W. C. (1997). Unilateral pallidal stimulation for Parkinson's disease: Neurobehavioral functioning before and 3 months after electrode implantation. Neurology 49: 1078–1083.

    Google Scholar 

  • Van Horn, G., Schiess, M. C., and Soukup, V. M. (2001). Subthalamic deep brain stimulation: Neurobehavioral concerns. Archives of Neurology 58: 1205–1206.

    Google Scholar 

  • Vingerhoets, G., van der Linden, C., Lannoo, E., Vandewalle, V., Caemaert, J., Wolters, M., and Van den Abbeele, D. (1999). Cognitive outcome after unilateral pallidal stimulation in Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry 66: 297–304.

    Google Scholar 

  • Volkmann, J., Allert, N., Voges, J., Weiss, P. H., Freund, H. J., and Sturm, V. (2001). Safety and efficacy of pallidal or subthalamic nucleus stimulation in advanced PD. Neurology 56: 548–551.

    Google Scholar 

  • Wichmann, T., Bergmann, J., and DeLong, M. R. (1994). The primate subthalamic nucleus. III. Changes in motor behavior and neuronal activity in the internal pallidum induced by subthalamic inactivation in the MPTP model of parkinsonism. Journal of Neurophysiology 72: 521–530.

    Google Scholar 

  • Wichmann, T., and DeLong, M. R. (1998). Models of basal ganglia function and pathophysiology of movement disorders. Neurosurgery Clinics of North America 9: 223–236.

    Google Scholar 

  • Wilkinson, S. B., and Tröster, A. I. (1998). Surgical interventions in neurodegenerative disease: Impact on memory and cognition. In Tröster, A. I. (ed.), Memory in Neurodegenerative Disease: Biological, Cognitive, and Clinical Perspectives, Cambridge University Press. Cambridge, pp. 362–376.

    Google Scholar 

  • Woods, S. P., Fields, J. A., Lyons, K. E., Koller, W. C., Wilkinson, S. B., Pahwa, R., and Tröster, A. I. (2001). Neuropsychological and quality of life changes following unilateral thalamic deep brain stimulation in Parkinson's disease: A one-year follow-up. Acta Neurochirurgica 143: 1273–1278.

    Google Scholar 

  • Woods, S. P., and Tröster, A. I. (in press). Prodromal frontal/executive dysfunction predicts incident dementia in Parkinson's disease. Journal of the International Neuropsychological Society.

  • Youdim, M. B., and Riederer, P. (1997). Understanding Parkinson's disease. Scientific American 1: 52–59.

    Google Scholar 

  • Zakzanis, K. K. (2001). Statistics to tell the truth, the whole truth, and nothing but the truth: Formulae, illustrative numerical examples, and heuristic interpretation of effect size analyses for neuropsychological researchers. Archives of Clinical Neuropsychology 16: 653–667.

    Google Scholar 

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  1. Department of Psychiatry and Behavioral Sciences, University of School of Medicine, Seattle, Washington

    Steven Paul Woods, Julie A. Fields & Alexander I. Tröster

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  1. Steven Paul Woods
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  2. Julie A. Fields
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  3. Alexander I. Tröster
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Woods, S.P., Fields, J.A. & Tröster, A.I. Neuropsychological Sequelae of Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease: A Critical Review. Neuropsychol Rev 12, 111–126 (2002). https://doi.org/10.1023/A:1016806711705

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