Cognitive and neuropsychiatric effects of subthalamotomy for Parkinson's disease.

Parkinsonism & Related Disorders
Scott BickelIrene Litvan

Abstract

Since the advent of deep brain stimulation (DBS) for the treatment of Parkinson's disease (PD), subsequent cognitive and neuropsychiatric effects of this procedure have become well-chronicled. Yet, thermolitic lesion of the subthalamic nucleus (STN) is still a valid option when DBS cannot be applied, and little has been published regarding its impact on cognition and mood. We examined the cognitive and neuropsychiatric functions of 10 consecutive patients with advanced PD undergoing simultaneous bilateral subthalamotomies. With 24 months of follow-up, the patients, three of whom were on anticholinergics prior to surgery, showed no deterioration in cognitive assessments including verbal fluency. Hypoactive behaviors (depression and apathy) showed lasting improvement, while hyperactive behaviors (euphoria and disinhibition) transiently increased after surgery. Improvement in hypoactive behaviors correlated with improvement in hypokinetic movements, and enhanced hyperactive behaviors followed the course of post-operative hyperkinetic movements. Such correlations may support the role of the STN in modulating limbic connections between the basal ganglia and frontal cortex. The results of this proof-of-concept pilot study suggest the...Continue Reading

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Citations

Jun 12, 2013·Behavioural Brain Research·Jean-Michel ReymannDanièle Bentué-Ferrer
Mar 15, 2013·Dementia and Geriatric Cognitive Disorders·S LaatuR Marttila
Oct 23, 2012·Journal of Neurosurgery·Vincent A JourdainThérèse Di Paolo
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Jan 17, 2017·Parkinsonism & Related Disorders·Franziska MaierLars Timmermann
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Jan 4, 2019·Journal of Cognitive Neuroscience·Jong H YoonCameron S Carter
Jan 1, 2012·Dementia & Neuropsychologia·Aline Juliane RomannMaira Rozenfeld Olchik
Mar 1, 2017·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·Marjan Jahanshahi, John C Rothwell
Nov 24, 2020·Frontiers in Neurology·Vishal RawjiLorenzo Rocchi
Apr 1, 2021·Expert Review of Neurotherapeutics·Jorge U Máñez-MiróJosé A Obeso

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