Verbal Fluency in Patients Receiving Bilateral versus Left-Sided Deep Brain Stimulation of the Subthalamic Nucleus for Parkinson's Disease

Sjöberg, Rickard L.; Lidman, Elin; Häggström, Björn; Hariz, Marwan; Lindér, Jan; Fredricks, Anna; Blomstedt, Patric

doi:10.1017/s1355617711001925

Cited by 16 publications

(18 citation statements)

References 19 publications

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“…In contrast to our results, a recent study showed more decline in verbal fluency in patients who received bilateral stimulation compared with only left-side stimulation, questioning the role of right STN in verbal fluency [34] .…”

Section: Verbal Fluencycontrasting

confidence: 99%

No Effect of Different Stimulation Conditions on Verbal Fluency and Visuospatial Orientation in Patients with Subthalamic Nucleus Deep Brain Stimulation

Yılmaz

Akbostancı²,

Mercan³

et al. 2015

Stereotact Funct Neurosurg

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Background: Subthalamic nucleus deep brain stimulation is an effective treatment for the symptomatic treatment of Parkinson's disease. Apart from the obvious motor benefits, some cognitive side effects have been reported, particularly in verbal fluency. Objectives: Our aim was to evaluate the effects of the stimulation on verbal fluency and visuospatial orientation with changing stimulation conditions in 35 patients with Parkinson's disease. Methods: Patients were randomized for their stimulation conditions as ‘both on', ‘both off', ‘right on', and ‘left on' and underwent verbal fluency and visuospatial orientation tasks during their drug-on periods. Letter and categorical fluency tasks and Benton's Judgment of Line Orientation Test were used for assessment. Results: Overall, 6 patients were excluded due to dementia or depression. For verbal fluency, the number of words they produced in 1 min was similar in four stimulation conditions (p > 0.05). No significant difference was found between stimulation conditions in the spatial orientation task. Conclusions: We were unable to find any significant changes in verbal fluency and visuospatial orientation task scores with different stimulation conditions. This result suggests that either stimulation has no effect on given domains or the effect is so small that more detailed batteries are required to detect the difference.

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Section: Verbal Fluencycontrasting

confidence: 99%

No Effect of Different Stimulation Conditions on Verbal Fluency and Visuospatial Orientation in Patients with Subthalamic Nucleus Deep Brain Stimulation

Yılmaz

Akbostancı²,

Mercan³

et al. 2015

Stereotact Funct Neurosurg

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“…[33] and Sjöberg et al . [31] Speech worsening also seems to be influenced by anteroposterior and mediolateral location because we observed more dysarthria for posterior and lateral locations; however, medial and anterior contact positions appear to be equally involved. [3334] This variability could be related to the patient studied and the method of contact location analysis used.…”

Section: Discussionmentioning

confidence: 88%

Subthalamus stimulation in Parkinson disease: Accounting for the bilaterality of contacts

Lemaire¹,

Pereira²,

Derost³

et al. 2016

Surg Neurol Int

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Background:Deep brain stimulation (DBS) in Parkinson's disease uses bi-hemispheric high-frequency stimulation within the subthalamus, however, the specific impacts of bilaterality of DBS are still not clear. Thus, we aimed to study the individual-level clinical impact of locations of right-left contact pair-up accounting for each subthalamic nucleus (STN) anatomy.Methods:Contact locations and effects at 1 year were studied retrospectively in an unselected series of 53 patients operated between 2004 and 2010. Location of contacts was defined relatively to the main axis of STN used to map longitudinal and transversal positions, and STN membership (out meaning out-of-STN). Contact pairings were described via three methods: (i) Unified contact location (UCL) collapsing DBS into an all-in-one contact; (ii) balance of contact pair-up (BCPU), defined as symmetric or asymmetric regardless of laterality; (iii) hemisphere-wise most frequent contact pair-up (MFCP) regardless of BCPU. Clinical data were: mean levodopa equivalent dose, Unified Parkinson's Disease Rating Scale (UPDRS) motor score III without medication, UPDRS II and III speech sub-scores, UPDRS II freezing sub-score, 1 year versus preoperative values, with and without levodopa. Ad-hoc two-sided tests were used for statistical analysis.Results:Worsening speech, was more frequent for UCL_out patients and when the left MFCP contact was rear and/or superolateral, however, it less frequent for BCPU-asymmetric patients. Worsening freezing was more frequent when the right MFCP contact was rear and superolateral.Conclusions:These results point to strategies for minimizing dysarthria and freezing as adverse effects of DBS.

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“…Specifically, there have been differential findings in Parkinson disease with most studies suggesting that neuropsychological performance remains unchanged [15] or improves across time with DBS (applied to the subthalamic nucleus), though one study reported a decrease in phonemic fluency. [16] Decreased verbal fluency secondary to DBS (applied to the anterior limb of the internal capsule) was also reported in a study to treat obsessive compulsive disorder. [17] Interestingly, a recent investigation [18, 19] found that DBS applied to the fornix improved performance in global cognitive function and memory for patients with Alzheimer’s disease.…”

Section: Introductionmentioning

confidence: 87%

Neuropsychological Function Before and After Subcallosal Cingulate Deep Brain Stimulation in Patients With Treatment-Resistant Depression

et al. 2014

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Background Treatment-resistant depression (TRD) is a pervasive and difficult to treat condition for which deep brain stimulation (DBS) of the subcallosal cingulate white matter (SCCwm) is an emerging therapeutic option. However, neuropsychological safety data for this novel treatment have only been published for a small number of subjects. Moreover, little is known regarding the neuropsychological profile present in TRD patients at baseline, prior to initiation of DBS therapy. This report describes the neuropsychological effects of TRD and acute and chronic DBS of the SCCwm in patients with unipolar and bipolar TRD. Methods Patients with TRD (N =17) were compared to a healthy control group (N = 15) on subtests from the Cambridge Neuropsychological Test Automated Battery and the Stroop Task. Patients were then tested again at subsequent time points of 1 and 6 months following the initiation of chronic DBS of the SCCwm. Results Patients with TRD showed similar levels of performance to healthy controls on most neuropsychological measures, with the exception that the TRD group had slower processing speed. Patients with bipolar TRD, relative to those with unipolar TRD, obtained lower scores on measures of executive function and memory only at baseline. With acute and chronic SCCwm DBS, neuropsychological function improved in multiple domains including processing speed and executive function (planning, set shifting, response inhibition), and memory remained stable. Conclusions Patients with TRD show slowed processing speed but otherwise largely preserved neuropsychological functioning. DBS of the SCCwm does not result in worsening of any aspect of neuropsychological function and may improve certain domains. Future research is warranted to better understand the effects of TRD and DBS on neuropsychological function.

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Verbal Fluency in Patients Receiving Bilateral versus Left-Sided Deep Brain Stimulation of the Subthalamic Nucleus for Parkinson's Disease

Cited by 16 publications

References 19 publications

No Effect of Different Stimulation Conditions on Verbal Fluency and Visuospatial Orientation in Patients with Subthalamic Nucleus Deep Brain Stimulation

No Effect of Different Stimulation Conditions on Verbal Fluency and Visuospatial Orientation in Patients with Subthalamic Nucleus Deep Brain Stimulation

Subthalamus stimulation in Parkinson disease: Accounting for the bilaterality of contacts

Neuropsychological Function Before and After Subcallosal Cingulate Deep Brain Stimulation in Patients With Treatment-Resistant Depression

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