Deep Brain Stimulation and Cognitive Functions in Parkinson's Disease: A Three-Year Controlled Study
Identifieur interne : 003020 ( Main/Merge ); précédent : 003019; suivant : 003021Deep Brain Stimulation and Cognitive Functions in Parkinson's Disease: A Three-Year Controlled Study
Auteurs : Roberta Zangaglia [Italie] ; Claudio Pacchetti [Italie] ; Chiara Pasotti [Italie] ; Francesca Mancini [Italie] ; Domenico Servello [Italie] ; Elena Sinforiani [Italie] ; Silvano Cristina [Italie] ; Marco Sassi [Italie] ; Giuseppe Nappi [Italie]Source :
- Movement disorders [ 0885-3185 ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
There is debate over the cognitive and behavioral effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in advanced Parkinson's disease (PD). To evaluate these effects, we performed a prospective, naturalistic controlled, 3-year follow-up study. A total of 65 PD patients were enrolled, of whom 32 underwent STN-DBS (PD-DBS) and 33, even though eligible for this treatment, declined surgery and chose other therapeutic procedures (PD-control). Motor and neuropsychological functions were assessed in all the subjects at baseline (TO) and 36 months (T36). The PD-DBS patients were also evaluated at 1,6, 12, and 24 months after surgery (T1, T6, T12, and T24). At T1, compared with T0, the PD-DBS patients recorded worse logical executive function task and verbal fluency (FAS) scores, whereas their performance of memory tasks remained stable. At T12, their cognitive profile had returned within the pre-DBS range, thereafter remaining stable until T36. FAS scores at T36 were significantly worse in the PD-DBS compared with the PD-control patients. This is the first long-term naturalistic controlled study of cognitive functions in PD patients submitted to STN-DBS. Our results confirm previous reports of a worsening of verbal fluency after DBS, but show that STN-DBS seems to be relatively safe from a cognitive standpoint, as the short-term worsening of frontal-executive functions was found to be transient.
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Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Laboratory of Neuropsychology, "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation></author><author><name sortKey="Cristina, Silvano" sort="Cristina, Silvano" uniqKey="Cristina S" first="Silvano" last="Cristina">Silvano Cristina</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Parkinson's Disease and Movement Disorders Unit, IRCCS "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Interdepartmental Research Center for Parkinson's Disease, "C. 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Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Neurology, University "La Sapienza</s1><s2>Rome</s2><s3>ITA</s3><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0386508</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0386508 INIST</idno><idno type="RBID">Pascal:09-0386508</idno><idno type="wicri:Area/PascalFrancis/Corpus">000D90</idno><idno type="wicri:Area/PascalFrancis/Curation">001F29</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000F23</idno><idno type="wicri:doubleKey">0885-3185:2009:Zangaglia R:deep:brain:stimulation</idno><idno type="wicri:Area/Main/Merge">003020</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Deep Brain Stimulation and Cognitive Functions in Parkinson's Disease: A Three-Year Controlled Study</title><author><name sortKey="Zangaglia, Roberta" sort="Zangaglia, Roberta" uniqKey="Zangaglia R" first="Roberta" last="Zangaglia">Roberta Zangaglia</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Parkinson's Disease and Movement Disorders Unit, IRCCS "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Interdepartmental Research Center for Parkinson's Disease, "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation></author><author><name sortKey="Pacchetti, Claudio" sort="Pacchetti, Claudio" uniqKey="Pacchetti C" first="Claudio" last="Pacchetti">Claudio Pacchetti</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Parkinson's Disease and Movement Disorders Unit, IRCCS "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Interdepartmental Research Center for Parkinson's Disease, "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation></author><author><name sortKey="Pasotti, Chiara" sort="Pasotti, Chiara" uniqKey="Pasotti C" first="Chiara" last="Pasotti">Chiara Pasotti</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Interdepartmental Research Center for Parkinson's Disease, "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Laboratory of Neuropsychology, "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation></author><author><name sortKey="Mancini, Francesca" sort="Mancini, Francesca" uniqKey="Mancini F" first="Francesca" last="Mancini">Francesca Mancini</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Unit of Neurology, San Pio X Institute</s1><s2>Milan</s2><s3>ITA</s3><sZ>4 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Servello, Domenico" sort="Servello, Domenico" uniqKey="Servello D" first="Domenico" last="Servello">Domenico Servello</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Unit of Functional Neurosurgery, IRCCS Galeazzi Insitute</s1><s2>Milan</s2><s3>ITA</s3><sZ>5 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Sinforiani, Elena" sort="Sinforiani, Elena" uniqKey="Sinforiani E" first="Elena" last="Sinforiani">Elena Sinforiani</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Interdepartmental Research Center for Parkinson's Disease, "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Laboratory of Neuropsychology, "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation></author><author><name sortKey="Cristina, Silvano" sort="Cristina, Silvano" uniqKey="Cristina S" first="Silvano" last="Cristina">Silvano Cristina</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Parkinson's Disease and Movement Disorders Unit, IRCCS "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Interdepartmental Research Center for Parkinson's Disease, "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation></author><author><name sortKey="Sassi, Marco" sort="Sassi, Marco" uniqKey="Sassi M" first="Marco" last="Sassi">Marco Sassi</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Unit of Functional Neurosurgery, IRCCS Galeazzi Insitute</s1><s2>Milan</s2><s3>ITA</s3><sZ>5 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Nappi, Giuseppe" sort="Nappi, Giuseppe" uniqKey="Nappi G" first="Giuseppe" last="Nappi">Giuseppe Nappi</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Interdepartmental Research Center for Parkinson's Disease, "C. Mondino Institute of Neurology" Foundation</s1><s2>Paνia</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Paνia</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Neurology, University "La Sapienza</s1><s2>Rome</s2><s3>ITA</s3><sZ>9 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Noyau sousthalamique</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">There is debate over the cognitive and behavioral effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in advanced Parkinson's disease (PD). To evaluate these effects, we performed a prospective, naturalistic controlled, 3-year follow-up study. A total of 65 PD patients were enrolled, of whom 32 underwent STN-DBS (PD-DBS) and 33, even though eligible for this treatment, declined surgery and chose other therapeutic procedures (PD-control). Motor and neuropsychological functions were assessed in all the subjects at baseline (TO) and 36 months (T36). The PD-DBS patients were also evaluated at 1,6, 12, and 24 months after surgery (T1, T6, T12, and T24). At T1, compared with T0, the PD-DBS patients recorded worse logical executive function task and verbal fluency (FAS) scores, whereas their performance of memory tasks remained stable. At T12, their cognitive profile had returned within the pre-DBS range, thereafter remaining stable until T36. FAS scores at T36 were significantly worse in the PD-DBS compared with the PD-control patients. This is the first long-term naturalistic controlled study of cognitive functions in PD patients submitted to STN-DBS. Our results confirm previous reports of a worsening of verbal fluency after DBS, but show that STN-DBS seems to be relatively safe from a cognitive standpoint, as the short-term worsening of frontal-executive functions was found to be transient.</div></front></TEI><affiliations><list><country><li>Italie</li></country><region><li>Latium</li><li>Lombardie</li></region><settlement><li>Milan</li><li>Rome</li></settlement></list><tree><country name="Italie"><noRegion><name sortKey="Zangaglia, Roberta" sort="Zangaglia, Roberta" uniqKey="Zangaglia R" first="Roberta" last="Zangaglia">Roberta Zangaglia</name></noRegion><name sortKey="Cristina, Silvano" sort="Cristina, Silvano" uniqKey="Cristina S" first="Silvano" last="Cristina">Silvano Cristina</name><name sortKey="Cristina, Silvano" sort="Cristina, Silvano" uniqKey="Cristina S" first="Silvano" last="Cristina">Silvano Cristina</name><name sortKey="Mancini, Francesca" sort="Mancini, Francesca" uniqKey="Mancini F" first="Francesca" last="Mancini">Francesca Mancini</name><name sortKey="Nappi, Giuseppe" sort="Nappi, Giuseppe" uniqKey="Nappi G" first="Giuseppe" last="Nappi">Giuseppe Nappi</name><name sortKey="Nappi, Giuseppe" sort="Nappi, Giuseppe" uniqKey="Nappi G" first="Giuseppe" last="Nappi">Giuseppe Nappi</name><name sortKey="Pacchetti, Claudio" sort="Pacchetti, Claudio" uniqKey="Pacchetti C" first="Claudio" last="Pacchetti">Claudio Pacchetti</name><name sortKey="Pacchetti, Claudio" sort="Pacchetti, Claudio" uniqKey="Pacchetti C" first="Claudio" last="Pacchetti">Claudio Pacchetti</name><name sortKey="Pasotti, Chiara" sort="Pasotti, Chiara" uniqKey="Pasotti C" first="Chiara" last="Pasotti">Chiara Pasotti</name><name sortKey="Pasotti, Chiara" sort="Pasotti, Chiara" uniqKey="Pasotti C" first="Chiara" last="Pasotti">Chiara Pasotti</name><name sortKey="Sassi, Marco" sort="Sassi, Marco" uniqKey="Sassi M" first="Marco" last="Sassi">Marco Sassi</name><name sortKey="Servello, Domenico" sort="Servello, Domenico" uniqKey="Servello D" first="Domenico" last="Servello">Domenico Servello</name><name sortKey="Sinforiani, Elena" sort="Sinforiani, Elena" uniqKey="Sinforiani E" first="Elena" last="Sinforiani">Elena Sinforiani</name><name sortKey="Sinforiani, Elena" sort="Sinforiani, Elena" uniqKey="Sinforiani E" first="Elena" last="Sinforiani">Elena Sinforiani</name><name sortKey="Zangaglia, Roberta" sort="Zangaglia, Roberta" uniqKey="Zangaglia R" first="Roberta" last="Zangaglia">Roberta Zangaglia</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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