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P2‐199: The effects of bilateral subthalamic nucleus deep brain stimulation on cognition in Parkinson's disease
Author(s) -
Heo Jae-Hyeok,
Kim Min Ky,
Ahn Jin Young,
Park Tai Hwan,
Lee Kyoung-Min,
Paek Sun Ha,
Jeon Beom S.
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.1273
Subject(s) - verbal fluency test , boston naming test , psychology , audiology , stroop effect , wisconsin card sorting test , trail making test , beck depression inventory , deep brain stimulation , cognition , neuropsychological test , mood , parkinson's disease , verbal learning , cognitive decline , psychiatry , neuropsychology , medicine , dementia , disease , anxiety
deficit (encoding deficit of visual and verbal sequences). This deficit mimics the “réponse à côté” (Ganser, 1898). Methods: 32 patients were included : a) 16 patients with a “Ganser-like” syndrome (GL group, mean age 58 years 6; mean MMSE 16.9 3,7) and b) 16 patients with typical AD (AD group; mean age 70 years 9; mean MMSE 18.8 2.3). The MMSE score was not different between groups (p 0.19). The neuropsychological performance and the perfusion profile (SPECT 99m Tc) of both groups were compared. Results: All patients of GL group presented with parietal symptoms. Gestural apraxia was the most frequent symptom (94% of patients), followed by simultagnosia and acalculia (88%). Between the two groups, working memory test performance was significantly different, both in verbal and visual modalities: 6,4 ( 1.89) for the GL group and of 9.9 ( 1.65) for the AD group for verbal and visual direct spans and 4 ( 1.89) for the GL group and of 7.3 ( 1.3) for the AD group for verbal and visual indirect spans. In the Grober and Buschke memory test which assesses long term episodic memory, the GL group had a lower encoding capacity than the AD group (p 0.0001): 4,39 ( 3.94) versus 9.12 ( 2.39), respectively. The comparison of SPECT data showed a more severe hypoperfusion in parietal regions in GL group, with a more severe deficit in the left hemisphere in 11 out of 16 patients. Conclusions: Severe short term memory deficit, resembling a pseudopsychiatric disorder, can be observed as an early sign of degenerative process in young patients. This clinical presentation is similar to the “réponse à côté” observed in Ganser’s syndrome. This symptomatology is associated with parietal atrophy. This new presentation is important to recognize and underlines the role of parietal regions in working memory process, as it has already been demonstrated by functional imaging studies.