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Cognition following bilateral deep brain stimulation surgery of the subthalamic nucleus for Parkinson's disease
Author(s) -
Halpern Casey H.,
Rick Jacqueline H.,
Danish Shabbar F.,
Grossman Murray,
Baltuch Gordon H.
Publication year - 2009
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2149
Subject(s) - deep brain stimulation , subthalamic nucleus , cognition , parkinson's disease , psychology , psychomotor learning , physical medicine and rehabilitation , executive functions , confounding , movement disorders , disease , neuroscience , cognitive decline , audiology , medicine , dementia
Objective Parkinson's disease (PD) is a neurodegenerative disorder characterized by significant motor dysfunction and various non‐motor disturbances, including cognitive alterations. Deep brain stimulation (DBS) is an increasingly utilized therapeutic option for patients with PD that yields remarkable success in alleviating disabling motor symptoms. DBS has additionally been associated with changes in cognition, yet the evidence is not consistent across studies. The following review sought to provide a clearer understanding of the various cognitive sequelae of bilateral subthalamic nucleus (STN) DBS while taking into account corresponding neuroanatomy and potential confounding variables. Design A literature search was performed using the following inclusion criteria: (1) at least five subjects followed for a mean of at least 3 months after surgery; (2) pre‐ and postoperative cognitive data using at least one standardized measure; (3) adequate report of study results using means and standard deviations. Results Two recent meta‐analyses found mild post‐operative impairments in verbal learning and executive function in patients who underwent DBS surgery. However, studies have revealed improved working memory and psychomotor speed in the ‘on’ vs ‘off’ stimulation state. A deficit in language may be a consequence of the surgical procedure. Conclusions While cognitive decline has been observed in some domains, our review of the data suggests that STN DBS is a worthwhile and safe method to treat PD. Copyright © 2008 John Wiley & Sons, Ltd.