Neuropsychological and quality of life assessment in patients with Parkinson's disease submitted to bilateral deep brain stimulation in the subthalamic nucleus

Heluani, A.; Porto, Fábio Henrique de Gobbi; Listik, Sérgio; Campos, Alexandre Walter de; Machado, A. A.; Cukiert, Arthur; Oliveira, José Oswaldo de

doi:10.1590/s1980-57642012dn06040010

Cited by 5 publications

(3 citation statements)

References 42 publications

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“…DBS patients exhibited deteriorations after surgery compared to preoperative performances in tasks of verbal fluency (59–77), memory (59, 62, 64, 66–68, 71, 72, 75, 77), executive function (59, 60, 64, 67, 69, 71, 72, 76–80), attention (66, 71), visuospatial functioning (59, 72, 75), global cognition (62, 74, 78), abstract reasoning (62), and processing speed (64, 72, 76, 77). A few studies observed no cognitive changes up to 3 months (81), in which individuals who did decline were significantly older, had higher levels of levodopa at baseline, and all had left implants in the GPi, up to 6 months (82, 83), and up to 5 years (84), in which there was a trend for a decline in verbal fluency. Within other studies, the outcomes of verbal fluency were variable.…”

Section: Parkinson's Diseasementioning

confidence: 99%

A Review of Cognitive Outcomes Across Movement Disorder Patients Undergoing Deep Brain Stimulation

2019

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Introduction: Although the benefit in motor symptoms for well-selected patients with deep brain stimulation (DBS) has been established, cognitive declines associated with DBS can produce suboptimal clinical responses. Small decrements in cognition can lead to profound effects on quality of life. The growth of indications, the expansion of surgical targets, the increasing complexity of devices, and recent changes in stimulation paradigms have all collectively drawn attention to the need for re-evaluation of DBS related cognitive outcomes. Methods: To address the impact of cognitive changes following DBS, we performed a literature review using PubMed. We searched for articles focused on DBS and cognition. We extracted information about the disease, target, number of patients, assessment of time points, cognitive battery, and clinical outcomes. Diseases included were dystonia, Tourette syndrome (TS), essential tremor (ET), and Parkinson's disease (PD). Results: DBS was associated with mild cognitive issues even when rigorous patient selection was employed. Dystonia studies reported stable or improved cognitive scores, however one study using reliable change indices indicated decrements in sustained attention. Additionally, DBS outcomes were convoluted with changes in medication dose, alleviation of motor symptoms, and learning effects. In the largest, prospective TS study, an improvement in attentional skills was noted, whereas smaller studies reported variable declines across several cognitive domains. Although, most studies reported stable cognitive outcomes. ET studies largely demonstrated deficits in verbal fluency, which had variable responses depending on stimulation setting. Recently, studies have focused beyond the ventral intermediate nucleus, including the post-subthalamic area and zona incerta. For PD, the cognitive results were heterogeneous, although deficits in verbal fluency were consistent and related to the micro-lesion effect. Conclusion: Post-DBS cognitive issues can impact both motor and quality of life outcomes. The underlying pathophysiology of cognitive changes post-DBS and the identification of pathways underpinning declines will require further investigation. Future studies should employ careful methodological designs. Patient specific analyses will be helpful to differentiate the effects of medications, DBS and the underlying disease state, including disease progression. Disease progression is often an underappreciated factor that is important to post-DBS cognitive issues.

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Section: Parkinson's Diseasementioning

confidence: 99%

A Review of Cognitive Outcomes Across Movement Disorder Patients Undergoing Deep Brain Stimulation

2019

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“…7 Targeting the STN significantly improves mobility, activities of daily life, and quality of life. 8,9 Placement of the DBS electrode is of importance for determining therapeutic effects since the STN has three parts, which form loops for somatosensory, associative, and limbic functions. In a single center study, one hundred and three patients with severe PD received bilateral STN stimulation and were followed up after 1 year.…”

Section: Dbs Of the Subthalamic Nucleus Targets Motor Complications I...mentioning

confidence: 99%

“…The subthalamic nucleus (STN) is the most popular target for DBS in PD 7 . Targeting the STN significantly improves mobility, activities of daily life, and quality of life 8,9 . Placement of the DBS electrode is of importance for determining therapeutic effects since the STN has three parts, which form loops for somatosensory, associative, and limbic functions.…”

Section: Dbs Of the Subthalamic Nucleus Targets Motor Complications I...mentioning

confidence: 99%

Deep brain stimulation: Challenges at the tissue‐electrode interface and current solutions

Kolaya

Firestein

2021

Biotechnology Progress

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Deep brain stimulation (DBS) is used to treat the motor symptoms of Parkinson's disease patients by stimulating the subthalamic nucleus. However, optimization of DBS is still needed since the performance of the neural electrodes is limited by the body's response to the implant. This review discusses the issues with DBS, such as placement of electrodes, foreign body response, and electrode degradation. The current solutions to these technical issues include modifications to electrode material, coatings, and geometry.

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Systematic Review and Meta-Analyses of Word Production Abilities in Dysfunction of the Basal Ganglia: Stroke, Small Vessel Disease, Parkinson’s Disease, and Huntington’s Disease

et al. 2022

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Clinical populations with basal ganglia pathologies may present with language production impairments, which are often described in combination with comprehension measures or attributed to motor, memory, or processing-speed problems. In this systematic review and meta-analysis, we studied word production in four (vascular and non-vascular) pathologies of the basal ganglia: stroke affecting the basal ganglia, small vessel disease, Parkinson's disease, and Huntington's disease. We compared scores of these clinical populations with those of matched cognitively unimpaired adults on four well-established production tasks, namely picture naming, category fluency, letter fluency, and past-tense verb inflection. We conducted a systematic search in PubMed and PsycINFO with terms for basal ganglia structures, basal ganglia disorders and language production tasks. A total of 114 studies were included, containing results for one or more of the tasks of interest. For each pathology and task combination, effect sizes (Hedges' g) were extracted comparing patient versus control groups. For all four populations, performance was consistently worse than that of cognitively unimpaired adults across the four language production tasks (p-values < 0.010). Given that performance in picture naming and verb inflection across all pathologies was quantified in terms of accuracy, our results suggest that production impairments cannot be fully explained by motor or processing-speed deficits. Our review shows that while language production difficulties in these clinical populations are not negligible, more evidence is necessary to determine the exact mechanism that leads to these deficits and whether this mechanism is the same across different pathologies.

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Neuropsychological and quality of life assessment in patients with Parkinson's disease submitted to bilateral deep brain stimulation in the subthalamic nucleus

Cited by 5 publications

References 42 publications

A Review of Cognitive Outcomes Across Movement Disorder Patients Undergoing Deep Brain Stimulation

A Review of Cognitive Outcomes Across Movement Disorder Patients Undergoing Deep Brain Stimulation

Deep brain stimulation: Challenges at the tissue‐electrode interface and current solutions

Systematic Review and Meta-Analyses of Word Production Abilities in Dysfunction of the Basal Ganglia: Stroke, Small Vessel Disease, Parkinson’s Disease, and Huntington’s Disease

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