Correlates of deep brain stimulation consensus conference decision to treat primary dystonia

Niccolai, Lindsay; Aita, Stephen L.; Walker, Harrison C.; Bene, Victor A. Del; Gerstenecker, Adam; Marotta, Dario A; Gammon, Meredith; Martin, Roy C.; Clay, Olivio J.; Crowe, Michael; Triebel, Kristen

doi:10.1016/j.clineuro.2021.106747

Cited by 6 publications

(11 citation statements)

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“…Findings from this meta‐analysis will add clarity to the disease‐specific typical cognitive profile of PwD. This information will improve clinical care of PwD, particularly with informing clinical diagnosis, treatment planning/recommendations, and neuropsychological assessment in presurgical deep brain stimulation (DBS) planning 27 . There is no comprehensive meta‐analysis of neurocognition in primary dystonia, and as Lange and colleagues 26 indicate, meta‐analysis overcomes the issue of small samples that characterize this literature by aggregating effects across study samples.…”

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confidence: 95%

“…This information will improve clinical care of PwD, particularly with informing clinical diagnosis, treatment planning/ recommendations, and neuropsychological assessment in presurgical deep brain stimulation (DBS) planning. 27 There is no comprehensive meta-analysis of neurocognition in primary dystonia, and as Lange and colleagues 26 indicate, meta-analysis overcomes the issue of small samples that characterize this literature by aggregating effects across study samples. As such, the current study provides a valuable foundation for future research in this area and also elucidates the relevance of nonmotor symptoms in primary dystonia for treatment providers.…”

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confidence: 99%

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Neuropsychological Functioning in Primary Dystonia: Updated and Expanded Multidomain Meta‐Analysis

et al. 2022

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A BS TRACT: Background: Primary dystonia is conventionally considered as a motor disorder, though an emerging literature reports associated cognitive dysfunction.Objectives: Here, we conducted meta-analyses on studies comparing clinical measures of cognition in persons with primary dystonia and healthy controls (HCs). Methods: We searched PubMed, Embase, Cochrane Library, Scopus, and PsycINFO (January 2000-October 2020). Analyses were modeled under random effects. We used Hedge's g as a bias-corrected estimate of effect size, where negative values indicate lower performance in dystonia versus controls. Between-study heterogeneity and bias were primarily assessed with Cochran's Q, I 2 , and Egger's regression. Results: From 866 initial results, 20 studies met criteria for analysis (dystonia n = 739, controls n = 643; 254 effect sizes extracted). Meta-analysis showed a significant combined effect size of primary dystonia across all studies (g = À0.56, P < 0.001), with low heterogeneity (Q = 25.26, P = 0.15, I 2 = 24.78). Within-domain effects of primary dystonia were motor speed = À0.84, nonmotor speed = À0.83, global cognition = À0.65, language = À0.54, executive functioning = À0.53, learning/memory = À0.46, visuospatial/construction = À0.44, and simple/complex attention = À0.37 (P-values <0.01). High heterogeneity was observed in the motor/nonmotor speed and learning/memory domains. There was no evidence of publication bias. Moderator analyses were mostly negative but possibly underpowered. Blepharospasm samples showed worse performance than other focal/cervical dystonias. Those with inherited (ie, genetic) disease etiology demonstrated worse performance than acquired. Conclusions: Dystonia patients consistently demonstrated lower performances on neuropsychological tests versus HCs. Effect sizes were generally moderate in strength, clustering around À0.50 SD units. Within the speed domain, results suggested cognitive slowing beyond effects from motor symptoms. Overall, findings indicate dystonia patients experience multidomain cognitive difficulties, as detected by neuropsychological tests.

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confidence: 95%

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Neuropsychological Functioning in Primary Dystonia: Updated and Expanded Multidomain Meta‐Analysis

et al. 2022

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“…Ressonância magnética funcional (RMF); técnica que facilita a detecção de pequenas alterações no fluxo sanguíneo, bem como na oxigenação dos tecidos cerebrais em que promove a ativação neuronal (Rilling, 2011;Niccolai, 2021).…”

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“…Estimulação transcraniana magnética (TMS): atua na delimitação da representação cortical, após aplicação de uma corrente elétrica sobre o escalpo. Induzindo que os campos magnéticos realizam campos elétricos que despolarizam neurônios corticais, produzindo um potencial de ação (Rilling, 2011;Niccolai, 2021).…”

Section: Recursos Neurocientíficos Para Identificar a Tomada De Decisõesunclassified

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Anatomia Microcirúrgica Do Hipocampo E Neurogênese

Lima¹,

Maioli²

2022

Neurologia: Perspectivas De Futuro E Posição Atual 2

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Direitos para esta edição cedidos à Atena Editora pelos autores. Open access publication by Atena Editora Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição-Não-Comercial-NãoDerivativos 4.0 Internacional (CC BY-NC-ND 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores, inclusive não representam necessariamente a posição oficial da Atena Editora. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais.Todos os manuscritos foram previamente submetidos à avaliação cega pelos pares, membros do Conselho Editorial desta Editora, tendo sido aprovados para a publicação com base em critérios de neutralidade e imparcialidade acadêmica.A Atena Editora é comprometida em garantir a integridade editorial em todas as etapas do processo de publicação, evitando plágio, dados ou resultados fraudulentos e impedindo que interesses financeiros comprometam os padrões éticos da publicação. Situações suspeitas de má conduta científica serão investigadas sob o mais alto padrão de rigor acadêmico e ético.

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Differential Cognitive Effects of Unilateral Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease

Del Bene,

Martin,

Brinkerhoff

et al. 2024

Annals of Neurology

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ObjectiveThe aim of this study was to investigate the cognitive effects of unilateral directional versus ring subthalamic nucleus deep brain stimulation (STN DBS) in patients with advanced Parkinson's disease.MethodsWe examined 31 participants who underwent unilateral STN DBS (left n = 17; right n = 14) as part of an National Institutes of Health (NIH)‐sponsored randomized, double‐blind, crossover study contrasting directional versus ring stimulation. All participants received unilateral DBS implants in the hemisphere more severely affected by motor parkinsonism. Measures of cognition included verbal fluency, auditory‐verbal memory, and response inhibition. We used mixed linear models to contrast the effects of directional versus ring stimulation and implant hemisphere on longitudinal cognitive function.ResultsCrossover analyses showed no evidence for group‐level changes in cognitive performance related to directional versus ring stimulation. Implant hemisphere, however, impacted cognition in several ways. Left STN participants had lower baseline verbal fluency than patients with right implants (t [20.66 = −2.50, p = 0.02]). Verbal fluency declined after left (p = 0.013) but increased after right STN DBS (p < 0.001), and response inhibition was faster following right STN DBS (p = 0.031). Regardless of hemisphere, delayed recall declined modestly over time versus baseline (p = 0.001), and immediate recall was unchanged.InterpretationDirectional versus ring STN DBS did not differentially affect cognition. Similar to prior bilateral DBS studies, unilateral left stimulation worsened verbal fluency performance. In contrast, unilateral right STN surgery increased performance on verbal fluency and response inhibition tasks. Our findings raise the hypothesis that unilateral right STN DBS in selected patients with predominant right brain motor parkinsonism could mitigate declines in verbal fluency associated with the bilateral intervention. ANN NEUROL 2024

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Correlates of deep brain stimulation consensus conference decision to treat primary dystonia

Cited by 6 publications

References 59 publications

Neuropsychological Functioning in Primary Dystonia: Updated and Expanded Multidomain Meta‐Analysis

Neuropsychological Functioning in Primary Dystonia: Updated and Expanded Multidomain Meta‐Analysis

Anatomia Microcirúrgica Do Hipocampo E Neurogênese

Differential Cognitive Effects of Unilateral Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease

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