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Five year follow-up of unilateral posteroventral pallidotomy in Parkinson’s disease

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Five year follow-up of unilateral posteroventral pallidotomy in Parkinson’s disease

Auteurs : Adriana Strutt [États-Unis] ; Eugene Lai [États-Unis] ; Joseph Jankovic [États-Unis] ; Farah Atassi [États-Unis] ; Elizabeth Soety [États-Unis] ; Harvey Levin [États-Unis] ; Robert Grossman [États-Unis] ; Michele York [États-Unis]

Source :

Surgical neurology [ 0090-3019 ] ; 2008.

RBID : PMC:2735757

English descriptors

KwdEn :
- Adult, Aged, Cognition Disorders (diagnosis), Cognition Disorders (etiology), Cognition Disorders (physiopathology), Female, Follow-Up Studies, Functional Laterality (physiology), Globus Pallidus (anatomy & histology), Globus Pallidus (surgery), Humans, Male, Memory Disorders (diagnosis), Memory Disorders (etiology), Memory Disorders (physiopathology), Mental Processes (physiology), Middle Aged, Neuropsychological Tests, Outcome Assessment (Health Care) (methods), Pallidotomy (adverse effects), Pallidotomy (methods), Pallidotomy (statistics & numerical data), Parkinson Disease (complications), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Postoperative Complications (diagnosis), Postoperative Complications (physiopathology), Postoperative Complications (psychology), Psychomotor Performance (physiology), Reaction Time (physiology), Retrospective Studies, Risk Assessment, Time Factors, Treatment Outcome.
MESH :
- adverse effects : Pallidotomy.
- anatomy & histology : Globus Pallidus.
- complications : Parkinson Disease.
- diagnosis : Cognition Disorders, Memory Disorders, Postoperative Complications.
- etiology : Cognition Disorders, Memory Disorders.
- methods : Outcome Assessment (Health Care), Pallidotomy.
- physiology : Functional Laterality, Mental Processes, Psychomotor Performance, Reaction Time.
- physiopathology : Cognition Disorders, Memory Disorders, Parkinson Disease, Postoperative Complications.
- psychology : Postoperative Complications.
- statistics & numerical data : Pallidotomy.
- surgery : Globus Pallidus, Parkinson Disease.
- Adult, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Retrospective Studies, Risk Assessment, Time Factors, Treatment Outcome.

Abstract

Background

Neurocognitive outcome research of individuals with Parkinson’s disease following unilateral pallidotomy is inconsistent. While some studies reported few cognitive changes, other investigations have more consistently shown both transient and long-term cognitive decline postoperatively.

Methods

We report the long-term motor and neurocognitive outcome 5 years post-surgery for 18 Parkinson’s disease patients (12 men and 6 woman; all right-handed) who underwent right or left unilateral posteroventral pallidotomy.

Results

Pallidotomy patients revealed long-term motor benefits from the surgery in their “off’ state and control of dopa-induced dyskinesias in their “on” state, which is consistent with previous research. We found mild declines in oral and visuo-motor information processing speed, verbal recognition memory, and mental status 5 years after surgery, which differs from previous literature regarding the long-term neurocognitive outcome following pallidotomy. Differences between the right and left pallidotomy patients for both motor and cognitive skills were not found.

Conclusion

Although deep brain stimulation is presently the treatment of choice, pallidotomy continues to be performed around the world. Consequently, while unilateral pallidotomy should be considered a treatment option for Parkinson’s disease patients who suffer from severe unilateral disabling motor symptoms or dyskinesias, the long-term neurocognitive outcome should also be considered in treatment decisions.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735757

DOI: 10.1016/j.surneu.2008.03.039
PubMed: 18514283
PubMed Central: 2735757

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PMC:2735757

Le document en format XML

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<affiliation wicri:level="2"><nlm:aff id="A5">Parkinson's Disease Research, Education and Clinical Center, Michael E. DeBakay VA Medical Center, Houston, Texas</nlm:aff>
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<author><name sortKey="Soety, Elizabeth M" sort="Soety, Elizabeth M" uniqKey="Soety E" first="Elizabeth" last="Soety">Elizabeth Soety</name>
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<author><name sortKey="York, Michele K" sort="York, Michele K" uniqKey="York M" first="Michele" last="York">Michele York</name>
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<author><name sortKey="Soety, Elizabeth M" sort="Soety, Elizabeth M" uniqKey="Soety E" first="Elizabeth" last="Soety">Elizabeth Soety</name>
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<author><name sortKey="Grossman, Robert G" sort="Grossman, Robert G" uniqKey="Grossman R" first="Robert" last="Grossman">Robert Grossman</name>
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<placeName><region type="state">Texas</region>
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<author><name sortKey="York, Michele K" sort="York, Michele K" uniqKey="York M" first="Michele" last="York">Michele York</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Cognition Disorders (diagnosis)</term>
<term>Cognition Disorders (etiology)</term>
<term>Cognition Disorders (physiopathology)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Functional Laterality (physiology)</term>
<term>Globus Pallidus (anatomy & histology)</term>
<term>Globus Pallidus (surgery)</term>
<term>Humans</term>
<term>Male</term>
<term>Memory Disorders (diagnosis)</term>
<term>Memory Disorders (etiology)</term>
<term>Memory Disorders (physiopathology)</term>
<term>Mental Processes (physiology)</term>
<term>Middle Aged</term>
<term>Neuropsychological Tests</term>
<term>Outcome Assessment (Health Care) (methods)</term>
<term>Pallidotomy (adverse effects)</term>
<term>Pallidotomy (methods)</term>
<term>Pallidotomy (statistics & numerical data)</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (surgery)</term>
<term>Postoperative Complications (diagnosis)</term>
<term>Postoperative Complications (physiopathology)</term>
<term>Postoperative Complications (psychology)</term>
<term>Psychomotor Performance (physiology)</term>
<term>Reaction Time (physiology)</term>
<term>Retrospective Studies</term>
<term>Risk Assessment</term>
<term>Time Factors</term>
<term>Treatment Outcome</term>
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<keywords scheme="MESH" qualifier="anatomy & histology" xml:lang="en"><term>Globus Pallidus</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Cognition Disorders</term>
<term>Memory Disorders</term>
<term>Postoperative Complications</term>
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<term>Memory Disorders</term>
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<term>Pallidotomy</term>
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<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Functional Laterality</term>
<term>Mental Processes</term>
<term>Psychomotor Performance</term>
<term>Reaction Time</term>
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<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Cognition Disorders</term>
<term>Memory Disorders</term>
<term>Parkinson Disease</term>
<term>Postoperative Complications</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Postoperative Complications</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Pallidotomy</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neuropsychological Tests</term>
<term>Retrospective Studies</term>
<term>Risk Assessment</term>
<term>Time Factors</term>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Neurocognitive outcome research of individuals with Parkinson’s disease following unilateral pallidotomy is inconsistent. While some studies reported few cognitive changes, other investigations have more consistently shown both transient and long-term cognitive decline postoperatively.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">We report the long-term motor and neurocognitive outcome 5 years post-surgery for 18 Parkinson’s disease patients (12 men and 6 woman; all right-handed) who underwent right or left unilateral posteroventral pallidotomy.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Pallidotomy patients revealed long-term motor benefits from the surgery in their “off’ state and control of dopa-induced dyskinesias in their “on” state, which is consistent with previous research. We found mild declines in oral and visuo-motor information processing speed, verbal recognition memory, and mental status 5 years after surgery, which differs from previous literature regarding the long-term neurocognitive outcome following pallidotomy. Differences between the right and left pallidotomy patients for both motor and cognitive skills were not found.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Although deep brain stimulation is presently the treatment of choice, pallidotomy continues to be performed around the world. Consequently, while unilateral pallidotomy should be considered a treatment option for Parkinson’s disease patients who suffer from severe unilateral disabling motor symptoms or dyskinesias, the long-term neurocognitive outcome should also be considered in treatment decisions.</p>
</sec>
</div>
</front>
</TEI>
</record>

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Five year follow-up of unilateral posteroventral pallidotomy in Parkinson’s disease

Five year follow-up of unilateral posteroventral pallidotomy in Parkinson’s disease

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