Neuropsychological consequences of chronic bilateral stimulation of the subthalamic nucleus in Parkinson's disease
Identifieur interne : 003467 ( Main/Exploration ); précédent : 003466; suivant : 003468Neuropsychological consequences of chronic bilateral stimulation of the subthalamic nucleus in Parkinson's disease
Auteurs : Jean A. Saint-Cyr [Canada] ; Lisa L. Tre Panier [Canada] ; Rajeev Kumar [États-Unis] ; Andres M. Lozano ; A. E. LangSource :
- Brain [ 0006-8950 ] ; 2000-10.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- ADL = activities of daily living, Affect, Age Factors, Aged, Attention, BEM = Batterie d'efficience mnésique, Bilateral, CALT = Conditional Associative Learning Test, CVLT = California Verbal Learning Test, Chronic, Cognition Disorders (diagnosis), Cognition Disorders (etiology), DBS = deep brain stimulation, Electric Stimulation Therapy (adverse effects), Exploration, FLOPS = Frontal Lobe Personality Scale, Female, Fingers (physiology), Follow-Up Studies, Frontal Lobe (physiology), GDI = Geriatric Depression Inventory, GPi = globus pallidus, internal segment, Human, Humans, Instrumental stimulation, Male, Memory, Middle Aged, Motor Activity, Neuropsychological Tests, Neuropsychological test, PASAT = Paced Auditory Serial Addition Test, PSP = Progressive Supranuclear Palsy, PVP = posteroventral pallidotomy, Parkinson Disease (physiopathology), Parkinson Disease (psychology), Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Personality, Photic Stimulation, Postoperative Complications (physiopathology), Postoperative Complications (psychology), Psychometrics, SMA = supplementary motor area, STN = subthalamic nucleus, Speech, Subthalamic Nucleus (physiology), Subthalamic nucleus, TMT = Trail Making Test, UPDRS = United Parkinson's disease Rating Scale, Verbal Learning, deep brain stimulation, fMRI = functional MRI, neuropsychology, subthalamic nucleus.
- MESH :
- adverse effects : Electric Stimulation Therapy.
- diagnosis : Cognition Disorders.
- etiology : Cognition Disorders.
- physiology : Fingers, Frontal Lobe, Subthalamic Nucleus.
- physiopathology : Parkinson Disease, Postoperative Complications.
- psychology : Parkinson Disease, Postoperative Complications.
- therapy : Parkinson Disease.
- Affect, Age Factors, Aged, Attention, Female, Follow-Up Studies, Humans, Male, Memory, Middle Aged, Motor Activity, Neuropsychological Tests, Personality, Photic Stimulation, Speech, Verbal Learning.
Abstract
The aim of this study was to examine possible neuropsychological changes in patients with advanced idiopathic Parkinson's disease treated with bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN). Eleven patients (age = 67 ± 8 years, years with Parkinson's disease = 15 ± 3, verbal IQ = 114 ± 12) were evaluated (in their best `on state') with tests assessing processes reliant on the functional integrity of frontal striatal circuitry, prior to the procedure (n = 11), at 3–6 months (n = 11) and at 9–12 months (n =10) post-operatively. Six of these patients were older than 69 years. Despite clinical motor benefits at 3–6 months post-operative, significant declines were noted in working memory, speed of mental processing, bimanual motor speed and co-ordination, set switching, phonemic fluency, long-term consolidation of verbal material and the encoding of visuospatial material. Declines were more consistently observed in patients who were older than 69 years, leading to a mental state comparable with progressive supranuclear palsy. `Frontal' behavioural dyscontrol without the benefit of insight was also reported by half (three of six) of the caregivers of the elderly subgroup. At 9–12 months postoperative, only learning based on multiple trials had recovered. Tasks reliant on the integrity of frontal striatal circuitry either did not recover or gradually worsened over time. Bilateral STN DBS can have a negative impact on various aspects of frontal executive functioning, especially in patients older than 69 years. Future studies will evaluate a larger group of patients and examine the possible reversibility of these effects by turning the DBS off.
Url:
DOI: 10.1093/brain/123.10.2091
Affiliations:
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Saint-Cyr</name><affiliation></affiliation><affiliation></affiliation><affiliation wicri:level="4"><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Tre Panier, Lisa L" sort="Tre Panier, Lisa L" uniqKey="Tre Panier L" first="Lisa L." last="Tre Panier">Lisa L. Tre Panier</name><affiliation></affiliation><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Department of Psychology, York University, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Kumar, Rajeev" sort="Kumar, Rajeev" uniqKey="Kumar R" first="Rajeev" last="Kumar">Rajeev Kumar</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Colorado Neurological Institute, Englewood, Colorado</wicri:regionArea><placeName><region type="state">Colorado</region></placeName></affiliation></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name><affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><title level="j" type="abbrev">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2000-10">2000-10</date><biblScope unit="volume">123</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="2091">2091</biblScope><biblScope unit="page" to="2108">2108</biblScope></imprint><idno type="ISSN">0006-8950</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>ADL = activities of daily living</term><term>Affect</term><term>Age Factors</term><term>Aged</term><term>Attention</term><term>BEM = Batterie d'efficience mnésique</term><term>Bilateral</term><term>CALT = Conditional Associative Learning Test</term><term>CVLT = California Verbal Learning Test</term><term>Chronic</term><term>Cognition Disorders (diagnosis)</term><term>Cognition Disorders (etiology)</term><term>DBS = deep brain stimulation</term><term>Electric Stimulation Therapy (adverse effects)</term><term>Exploration</term><term>FLOPS = Frontal Lobe Personality Scale</term><term>Female</term><term>Fingers (physiology)</term><term>Follow-Up Studies</term><term>Frontal Lobe (physiology)</term><term>GDI = Geriatric Depression Inventory</term><term>GPi = globus pallidus, internal segment</term><term>Human</term><term>Humans</term><term>Instrumental stimulation</term><term>Male</term><term>Memory</term><term>Middle Aged</term><term>Motor Activity</term><term>Neuropsychological Tests</term><term>Neuropsychological test</term><term>PASAT = Paced Auditory Serial Addition Test</term><term>PSP = Progressive Supranuclear Palsy</term><term>PVP = posteroventral pallidotomy</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (psychology)</term><term>Parkinson Disease (therapy)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Personality</term><term>Photic Stimulation</term><term>Postoperative Complications (physiopathology)</term><term>Postoperative Complications (psychology)</term><term>Psychometrics</term><term>SMA = supplementary motor area</term><term>STN = subthalamic nucleus</term><term>Speech</term><term>Subthalamic Nucleus (physiology)</term><term>Subthalamic nucleus</term><term>TMT = Trail Making Test</term><term>UPDRS = United Parkinson's disease Rating Scale</term><term>Verbal Learning</term><term>deep brain stimulation</term><term>fMRI = functional MRI</term><term>neuropsychology</term><term>subthalamic nucleus</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Cognition Disorders</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cognition Disorders</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Fingers</term><term>Frontal Lobe</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Affect</term><term>Age Factors</term><term>Aged</term><term>Attention</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Memory</term><term>Middle Aged</term><term>Motor Activity</term><term>Neuropsychological Tests</term><term>Personality</term><term>Photic Stimulation</term><term>Speech</term><term>Verbal Learning</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Bilatéral</term><term>Chronique</term><term>Exploration</term><term>Homme</term><term>Noyau sousthalamique</term><term>Parkinson maladie</term><term>Psychométrie</term><term>Stimulation instrumentale</term><term>Test neuropsychologique</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to examine possible neuropsychological changes in patients with advanced idiopathic Parkinson's disease treated with bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN). Eleven patients (age = 67 ± 8 years, years with Parkinson's disease = 15 ± 3, verbal IQ = 114 ± 12) were evaluated (in their best `on state') with tests assessing processes reliant on the functional integrity of frontal striatal circuitry, prior to the procedure (n = 11), at 3–6 months (n = 11) and at 9–12 months (n =10) post-operatively. Six of these patients were older than 69 years. Despite clinical motor benefits at 3–6 months post-operative, significant declines were noted in working memory, speed of mental processing, bimanual motor speed and co-ordination, set switching, phonemic fluency, long-term consolidation of verbal material and the encoding of visuospatial material. Declines were more consistently observed in patients who were older than 69 years, leading to a mental state comparable with progressive supranuclear palsy. `Frontal' behavioural dyscontrol without the benefit of insight was also reported by half (three of six) of the caregivers of the elderly subgroup. At 9–12 months postoperative, only learning based on multiple trials had recovered. Tasks reliant on the integrity of frontal striatal circuitry either did not recover or gradually worsened over time. Bilateral STN DBS can have a negative impact on various aspects of frontal executive functioning, especially in patients older than 69 years. Future studies will evaluate a larger group of patients and examine the possible reversibility of these effects by turning the DBS off.</div></front></TEI><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Colorado</li><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Saint Cyr, Jean A" sort="Saint Cyr, Jean A" uniqKey="Saint Cyr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name></region><name sortKey="Tre Panier, Lisa L" sort="Tre Panier, Lisa L" uniqKey="Tre Panier L" first="Lisa L." last="Tre Panier">Lisa L. Tre Panier</name></country><country name="États-Unis"><region name="Colorado"><name sortKey="Kumar, Rajeev" sort="Kumar, Rajeev" uniqKey="Kumar R" first="Rajeev" last="Kumar">Rajeev Kumar</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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