An Assessment of Cognitive Function in Postthalamotomy Parkinson Patients

Abstract

Cognitive evaluation of 47 Parkinson patients for a mean of 17 months following unilateral thalamotomy, using the Wechsler-Bellevue adult intelligence scale and the Wechsler memory scale, showed mild but definite cognitive declines persisting into the second postoperative year. Left-side operated patients showed declines mainly in verbally related scores and right-side operated patients showed declines mainly in nonverbal performance scores. These left-right differences were not secondarily caused by differences in age, sex, or degree of disease severity. A lack of adequate control data in the current literature prevents relating these changes directly to the thalamus. The changes observed are not sufficient in themselves to warrant cessation of thalamotomy in the treatment of Parkinson''s disease.

Stereotactic ventrolateralis thalamotomy for medically refractory tremor in post-levodopa era Parkinson's disease patients

“…Cognitive deficits are also known to occur following thalamotomyJ ~ Waltz, et al, 63 reported transient confusion and disorientation in approximately 10% of their patients, but they cleared within 1 to 7 days postoperatively. Shapiro, et al, 52 reported more permanent albeit mild cognitive deficits in 10% to 15 % of their patients. Left thalamic lesions have been associated with verbal memory and learning deficits, while fight thalamic lesions have been linked to impaired visuospatial memory and nonverbal performance abilities.…”

Cognitive and Behavioral Changes After Surgery and Deep Brain Stimulation in Parkinson’s Disease

“…Burchiel KJ [3] noted that 39% of thalamotomy patients demonstrated decline in speech, language and memory which was more prevalent among bilateral then unilateral operates 60% versus 31% Case series and studies found that verbal memory declined after unilateral left and bilateral thalamotomy Shapiro DY, et al [4] but not after unilateral right thalamotomy [5]. Transient attention declines Riklan M, et al [6], transient reduction in verbal fluency were also found after left and bilateral thalamotomy.…”

Neurological Surgery at the National Institutes of Health

“…Among his trainees was George A. Ojemann, M.D., who would go on to a distinguished career in neurosurgery, making several critical contributions to the surgical treatment of epilepsy. Later, Dr. Baldwin began clinical work at the NIH on surgery for movement disorders, including thalamotomy for Parkinson’s disease 81,86. However, his most lasting discoveries related to movement disorders were a result of his research interest in neuroanatomy.…”