Cognitive changes in Parkinson's disease during subthalamic stimulation: a clinicopathologic study

Valldeoriola, Francesc; Tolosa, Eduardo; Alegret, Montserrat; Rey, M.; Morsi, Ossama; Pilleri, Manuela; Rumià, Jordi

doi:10.1136/jnnp.2005.077990

Cited by 8 publications

(17 citation statements)

References 6 publications

(6 reference statements)

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“…We found a total of 40 unique cases with 58 electrodes implanted for the treatment of a variety of movement disorders, pain, and other neurologic disorders. These cases were systematically reviewed and are summarized in detail in Table .…”

Section: Resultsmentioning

confidence: 99%

Neurohistopathological Findings at the Electrode–Tissue Interface in Long-Term Deep Brain Stimulation: Systematic Literature Review, Case Report, and Assessment of Stimulation Threshold Safety

DiLorenzo

Jankovic

Simpson

et al. 2014

Neuromodulation: Technology at the Neural Interface

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Section: Resultsmentioning

confidence: 99%

Neurohistopathological Findings at the Electrode–Tissue Interface in Long-Term Deep Brain Stimulation: Systematic Literature Review, Case Report, and Assessment of Stimulation Threshold Safety

DiLorenzo

Jankovic

Simpson

et al. 2014

Neuromodulation: Technology at the Neural Interface

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“…The sample size of the studies varied, from case reports, as in eleven percent or 9/83 of studies (3,12,14,20,24,27,92,96,126) to case series as large as 96 subjects (15). Indication for STN DBS across studies was idiopathic Parkinson's disease (n= 83) and the disease duration was 14.28 years (SD = 3.56), with an average age of patients operated being 57.7 years (SD = 6.29).…”

Section: General Characteristicsmentioning

confidence: 99%

“…In sixty-three percent or 52/83 of studies, the "Unified Parkinson's Disease Rating Scale", UPDRS, was applied (1,7,8,9,10,13,16,19,21,22,23,26,30,31,34,35,36,37,38,39,40,43,44,45,92,93,94,95,96,98,100,103,108,111,112,113,114,115,116,117,118,119,120,121,121,123,124,125,129,130,137,138).…”

Section: Presurgical Screeningmentioning

confidence: 99%

“…In only twenty-four percent or 20/83 of studies, the "Mini Mental State Examination", MMSE, was used (4,6,8,9,25,27,31,32,43,91,94,96,100,108,122,124,126,128,130,138) and in nineteen percent or 16/83 of studies, the Mattis Dementia rating Scale (MDRS) was administered (1,6,7,9,15,26,27,33,41,45,91,99,110,116,126,129). Finally other pre-operative evaluation testes were used in seventy-five percent or 62/83 of studies (1,3,4,5,7,8,9,10,11,12,13,14,15,16,…”

Section: Presurgical Screeningmentioning

confidence: 99%

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Clinical review of deep brain stimulation and its effects on limbic basal ganglia circuitry

Saleh¹

2008

Front Biosci

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This paper aims to provide an overview of factors that may contribute to cognitive and mood alterations following DBS (and lesion therapy). A PubMed search based on studies in the English-language was undertaken, and included all publications on the topics of mood and surgery for movement disorders. Information was collected on pre-operative and post-operative characteristics of each study, and study methodology was examined. One-hundred and forty published articles were selected and reviewed for mood and behavior changes following neurosurgery for movement disorders. There were a variety of mood and cognitive changes associated with DBS (and lesion therapy). These alterations of behavior and cognition were seen in all targets but not frequently reported with thalamic DBS. However methodological limitations, small sample sizes, lack of control groups, and the heterogeneity of data reported underscore why interpretation and comparison of limbic effects of DBS remains challenging. The collection and reporting of more standardized minimal data sets will allow for future comparisons, and improve the power required to answer many of the questions raised in this review.

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“…Other potential risk factors for cognitive deterioration have not been established, but include more advanced age (>69 years; refs. 87,217,255) and pre-existing cognitive deficits (266)(267)(268). While age appears to predispose to postoperative confusional episodes (269) and poorer executive function outcome in the long term after STN DBS (240), it does not necessarily confer risk for poorer cognitive short-term outcomes (215).…”

Section: Factors Underlying Cognitive Changes After Stn Dbsmentioning

confidence: 99%

Neuropsychological Issues in Deep Brain Stimulation of Neurological and Psychiatric Disorders

Tröster

McTaggart

Heber

2008

Deep Brain Stimulation in Neurological and Psychiatric Disorders

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The past decade has seen an explosion in the number of medically refractory conditions and neuroanatomical structures targeted for DBS treatment. While a review of the literature and meta-analyses indicate DBS for movement disorders to be safe from a neurobehavioral standpoint it is also clear that a small subset of patients have experienced moderate or severe neurobehavioral morbidity. If one combines the various cognitive and psychiatric morbidities reported across studies, approximately 10% of patients with PD undergoing DBS have experienced one or another neurobehavioral adverse events. Furthermore, several small studies have indicated that improvements in motor symptoms and quality of life (QOL) may not necessarily translate into social readjustment. A greater role for ancillary health services, such as speech therapy, occupational and physical therapy, neuropsychology, and psychotherapy needs to be contemplated. Health care providers should not rely on subjective impression or spontaneous patient report to identify neurobehavioral and psychosocial issues. Recent consensus statements on patient selection, treatment, and outcome evaluation should facilitate greater uniformity in outcome reporting and identification of neurobehavioral risk.What has proved elusive is the identification of reliable predictors and risk factors for such neurobehavioral changes. Ethical concerns and methodological limitations hinder the initiation of more sophisticated, controlled, blinded, comparative trials with large numbers of subjects needed to isolate predictors of neurobehavioral and QOL outcomes. Similarly, it is difficult to conclude at present that stimulation alone is associated with neurobehavioral morbidity, though in some cases, there are replicable effects on mood and cognition when stimulation is turned on and off. In the case of PD, and likely many of the disorders for which DBS is beginning to be investigated, outcomes may be related to an interaction of the surgical procedure and stimulation as well as subsequent changes in medications, psychosocial factors and pre-operative vulnerability. Conclusions that DBS is neuropsychologically safe in conditions such as dystonia, depression, obsessive compulsive diorder (OCD), Tourette syndrome (TS), epilepsy, multiple sclerosis (MS) and others must be considered highly preliminary until NJ 400 A.I. Tröster et al.adequate controlled trials are completed. The emergence of cognitive and social neuroscience studies of DBS, particularly when accompanied by functional neuroimaging, are encouraging signs that DBS may be used as a vehicle to better understand the cognitive and behavioral roles of the basal ganglia.

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Cognitive changes in Parkinson's disease during subthalamic stimulation: a clinicopathologic study

Cited by 8 publications

References 6 publications

Neurohistopathological Findings at the Electrode–Tissue Interface in Long-Term Deep Brain Stimulation: Systematic Literature Review, Case Report, and Assessment of Stimulation Threshold Safety

Neurohistopathological Findings at the Electrode–Tissue Interface in Long-Term Deep Brain Stimulation: Systematic Literature Review, Case Report, and Assessment of Stimulation Threshold Safety

Clinical review of deep brain stimulation and its effects on limbic basal ganglia circuitry

Neuropsychological Issues in Deep Brain Stimulation of Neurological and Psychiatric Disorders

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