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Cognitive and behavioral changes after unilateral posteroventral pallidotomy: Relationship with lesional data from MRI
Author(s) -
Junqué Carme,
Alegret Montse,
Nobbe Frederich A.,
Valldeoriola Francesc,
Pueyo Roser,
Vendrell Pere,
Tolosa Eduardo,
Rumià Jordi,
Mercader Josep Maria
Publication year - 1999
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/1531-8257(199909)14:5<780::aid-mds1010>3.0.co;2-g
Subject(s) - lesion , verbal fluency test , psychology , audiology , pallidotomy , analysis of variance , magnetic resonance imaging , central nervous system disease , cognition , parkinson's disease , neuropsychology , medicine , disease , neuroscience , radiology , pathology , psychiatry , deep brain stimulation
We investigated cognitive and behavioral changes after unilateral posteroventral pallidotomy, and their relationship with lesion size and location as identified in magnetic resonance image quantitative analysis. Fifteen consecutive patients with Parkinson's disease were assessed neuropsychologically before and after unilateral posteroventral pallidotomy (five right and 10 left). Immediate postsurgery evaluation (1 week) demonstrated significant worsening of memory, motor learning, motor speed, and verbal fluency. In the 3‐month follow up, learning, memory, and speed returned to the presurgical level, but verbal fluency remained below the baseline. Significant improvements were observed in visuospatial functions and obsessive‐compulsive behavior. Lesional volume did not correlate with neuropsychologic changes. Left lesions produced more impairment in verbal fluency than right‐sided lesions. Regression analysis identified two lesional areas in the pallidum mediale internum. These regions accounted for 68% of the variance in the visuospatial changes.