Neuropsychological changes 1-year after subthalamic DBS in PD patients: A prospective controlled study

Parkinsonism Relat Disord. 2010 Feb;16(2):115-8. doi: 10.1016/j.parkreldis.2009.08.010. Epub 2009 Sep 22.

Abstract

Objective: This study aimed at investigating the neuropsychological effect of DBS of the Subthalamic Nucleus in patients with advanced Parkinson's disease (PD).

Methods: A standardized neuropsychological test battery, assessing reasoning, memory and executive functions, was administered to 27 PD patients who underwent DBS-STN (DBS group) and to a matched control group of 31 PD patients under optimal medical treatment (MED group). Patients were evaluated at baseline and at the end of 1 year.

Results: Change score analysis (T1 minus T0 scores) demonstrated a significant decline in phonemic verbal fluency in the DBS group compared with the MED group (p < 0.005), while there were no significant changes between the two groups for the other cognitive tests. Single cases analysis by means of multivariate normative comparisons revealed that 4 out of 27 DBS patients (15%) showed cognitive deterioration one year post surgery. These patients were significantly more compromised from a motor standpoint (UPDRS, section III) than the 23 DBS PD patients who had no cognitive decline post surgery.

Conclusion: Results of this prospective controlled-study showed that phonemic verbal fluency declined one year after DBS-STN, while the other cognitive domains did not change significantly. Nevertheless, single case analysis highlighted the fact that a subgroup comprising 15% of DBS-STN patients (4/27) showed significant cognitive decline 1 year after surgery.

MeSH terms

  • Aged
  • Analysis of Variance
  • Cognition Disorders / etiology*
  • Cognition Disorders / therapy*
  • Deep Brain Stimulation / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neuropsychological Tests
  • Parkinson Disease / complications*
  • Parkinson Disease / therapy
  • Prospective Studies
  • Statistics, Nonparametric
  • Subthalamus / physiology*