One Year after Deep Brain Stimulation at Parkinson’s Disease Patients – Neuropsychological Results

Česká verzia

Authors: S. Telecká; M. Baláž; I. Rektorová; Z. Fanfrdlová; I. Rektor
Authors place of work: Centrum pro abnormní pohyby a parkinsonismus, I. neurologická klinika LF MU a FN u sv. Anny v Brně
Published in the journal: Cesk Slov Neurol N 2010; 73/106(1): 57-61
Category: Short Communication

Summary

Aim of the study:
To evaluate cognitive status one year after deep brain stimulation of the subthalamic nucleus in Parkinson’s disease patients.

Method:
Nineteen non‑demented patients underwent neuropsychological assessment before and one year after deep brain stimulation in the “ON” motor state. The Wilcoxon test for two paired samples was used for data analyses.

Results:
All the patients experienced a long‑term improvement of motor performance and alleviation of motor complications with the “ON” stimulation. Analyses revealed decline in the following tests: the “word and colour” part of the Stroop Test; a semantic and lexical verbal fluency test; a picture completion task and a “word list – delayed recall” verbal learning test.

Conclusion:
We found mild but statistically significant decline in the results of tests measuring attention, executive functions and verbal memory (free recall). Mood scores (depression) were not influenced by DBS.

Key words:
deep brain stimulation – subthalamic nucleus – cognitive symptoms – depression

Zdroje

1. Baláž M, Rektor I. Neuropsychologické a kognitivní vlivy hluboké mozkové stimulace subtalamického jádra u pacientů s Parkinsonovou nemocí. Neurol pro praxi 2008; 9(5): 305–307.

2. Witt K, Daniels C, Reiff J, Krack P, Volkmann J, Pinsker RO et al. Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s disease: a randomised, multicentral study. Lancet Neurol 2008; 7(7): 605–614.

3. Krack P, Batir A, Van Blercom N, Chabardes S, Fraix V, Ardouin C et al. Five‑year follow‑up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 2003; 349(20): 1925–1934.

4. Houeto JL, Damier P, Bejjani PB, Staedler C, Bonnet AM, Arnulf I et al. Subthalamic stimulation in Parkinson’s disease: a multidisciplinary approach. Arch Neurol 2000; 57(4): 461–465.

5. Chrastina J, Novák Z, Baláž M, Krupa P, Říha I, Jančálek R et al. Subthalamic nucleus stimulation – surgical problems. Neurol pro praxi, 2006; 2 (Suppl B): B45.

6. Higginson CI, Wheelock VL, Levine D, King DS, Pappas CT, Sivgardt KA. The clinical significance of neuropsychological changes following bilateral subthalamic nucleus deep brain stimulation for Parkinson’s disease. J Clin and Exp Neuropsychol 2009; 31(1): 65–72.

7. York MK, Dulay M, Macias A, Levin HS, Grossmann R,Simpson R et al. Cognitive declines following bilateral subthalamic nucleus deep brain stimulation for the treatment of Parkinson’s disease. J Neurol Neurosurg Psychiatry 2008; 79(7):789–795.

8. Rektorová I. Neurodegenerativní demence. Cesk Slov Neurol N 2009; 72/105(2): 97–109.

9. Aarsland D, Andersen K, Larsen JP, Lolk A, Kragh‑Sørensen P. Prevalence and characteristics of dementia in Parkinson disease: an 8‑year prospective study. Arch Neurol 2003; 60(3): 387–392.

10. Emre M, Aarsland D, Brown R, Burn DJ, Duyckaerts C, Mizuno Y et al. Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 2007; 22(12): 1689–1707.

11. Wechsler D. Wechslerova inteligenční škála pro dospělé. 3rd ed. Brno: Psychodiagnostika 1999.

12. Randolph C, Mohr E, Chase TN. Assessment of intellectual function in dementing disorders: validity of WAIS‑R short forms for patients with Alzheimer’s, Huntington’s, and Parkinson’s disease. J Clin Experiment Neuropsychol 1993; 15(5): 743–753.

13. Mattis S. Dementia rating scale: professional manual. Odessa: Psychological Assessment Resources 1988.

14. Wechsler D. Wechslerova paměťová škála. 3rd ed. Brno: Psychodiagnostika 1999.

15. Meyers JE, Meyers KR. Rey Complex figure test and recognition trial. Odessa, Florida, USA: Psychological Assessment Resources 1996.

16. Stroop Color and Word Test – adult version. Odessa, Florida, USA: Psychological Assessment Resources 2002.

17. Shallice T, Evans M. The involvement of the frontal lobes in cognitive estimation. Cortex 1978; 14(2): 294–303.

18. Beck AT, Steer RA. Beck depression inventory manual. San Antonio, Texas, USA: Psychological Corporation 1993.

19. Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Brit J Psych 1979; 134: 382–389.

20. Aybek S, Gronchi‑Perrin A, Berney A, Chiuvé SC, Villemure JG, Burkhard PR et al. Long‑term cognitive profile and incidence of dementia after STN‑DBS in Parkinson’s disease. Mov Disord 2007; 22(7): 974–981.

21. Klempírová O, Jech R, Urgosík D, Klempír J, Spačková N, Roth J et al. Deep brain stimulation of the subthalamic nucleus and cognitive functions in Parkinson’s disease. Prague Med Rep 2007; 108(4): 315–323.

22. Kleiner‑Fisman G, Herzog J, Fisman DN, Tamma F,Lyons KE, Pahwa R et al. Subthalamic nucleus deep brain stimulation: summary and meta‑analysis of outcomes. Mov Disord 2006; 21 (Suppl 14): S290–S304.

23. Parsons TD, Rogers SA, Braaten AJ, Woods SP, Tröster AI. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: a meta‑analysis. Lancet Neurol 2006; 5(7): 578–588.

24. Page D, Jahanshahi M. Deep brain stimulation of the subthalamic nucleus improves set shifting but does not affect dual task performance in Parkinson’s disease. IEEE Trans Neural Syst Rehabil Eng 2007; 15(2): 198–206.

25. Jahanshahi M, Ardouin CM, Brown RG, Rothwell JC, Obeso J, Albanese A et al. The impact of deep brain stimulation on executive function in Parkinson’s disease. Brain 2000; 123(6): 1142–1154.

26. Strafella AP, Dagher A, Sadikot AF. Cerebral blood flow changes induced by subthalamic stimulation in Parkinson’s disease. Neurology 2003; 60(6): 1039–1042.

27. Campbell MC, Karimi M, Weaver PM, Wu J, Perantie DC, Golchin NA et al. Neural correlates of STN DBS‑induced cognitive variability in Parkinson disease. Neuropsychologia 2008; 46(13): 3162–3169.

28. Okun MS, Fernandez HH, Wu SS, Kirsch‑Darrow L,Bowers D, Bova F et al. Cognition and mood in Parkinson’s disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: the COMPARE trial. Ann Neurol 2009; 65(5): 586–595.

29. Voon V, Kubu C. Krack P, Houeto JL, Tröster AI. Deep brain stimulation: neuropsychological and neuropsychiatric issues. Mov Disord 2006; 21 (Suppl 14): S305–S327.

30. NINDS Deep Brain Stimulation for Parkinson’s Disease Information Page. Dostupné z: www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm.