Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease.
Identifieur interne : 002C29 ( Ncbi/Curation ); précédent : 002C28; suivant : 002C30Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease.
Auteurs : Christine Daniels [Allemagne] ; Paul Krack ; Jens Volkmann ; Markus O. Pinsker ; Martin Krause ; Volker Tronnier ; Manja Kloss ; Alfons Schnitzler ; Lars Wojtecki ; Kai Bötzel ; Adrian Danek ; Rüdiger Hilker ; Volker Sturm ; Andreas Kupsch ; Elfriede Karner ; Günther Deuschl ; Karsten WittSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2010.
English descriptors
- KwdEn :
- Aged, Cognition Disorders (etiology), Deep Brain Stimulation (adverse effects), Executive Function (physiology), Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Parkinson Disease (physiopathology), Parkinson Disease (therapy), Risk Factors, Statistics as Topic, Subthalamic Nucleus (physiology).
- MESH :
- adverse effects : Deep Brain Stimulation.
- etiology : Cognition Disorders.
- physiology : Executive Function, Subthalamic Nucleus.
- physiopathology : Parkinson Disease.
- therapy : Parkinson Disease.
- Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Risk Factors, Statistics as Topic.
Abstract
A slight decline in cognitive functions and especially in executive functioning after deep brain stimulation (DBS) of the nucleus subthalamicus (STN) in patients with Parkinson's disease (PD) has been described. This study evaluated baseline parameters that contribute to a deterioration of cognitive functioning after DBS. We analyzed data from the neuropsychological protocol in a randomized controlled study comparing DBS with best medical treatment (BMT). Change scores were calculated for the cognitive domains "global cognitive functioning," "memory," "working memory," "attention," and "executive function." These domain-specific change scores were correlated with previously defined preoperative parameters. Compared with the BMT group (63 patients), the STN-DBS group (60 patients) showed a significant decline only in the domain executive function 6 months after DBS, which was significantly correlated with age, levodopa-equivalence dosage (LED) and axial subscore of the UPDRS in the off-medication state at baseline. Multiple regression analysis showed that these three factors explained, however, only about 23% of the variance. Patients with higher age, higher baseline LED, and/or higher axial subscore of the UPDRS at baseline have an increased risk for worsening of executive function after STN-DBS. High scores of these factors might reflect an advanced stage of disease progression. As these baseline factors explained the variance of the change score executive function only to a minor proportion, other factors including the surgical procedure, the exact placement of the electrode or postsurgical management might be more relevant for a decline in executive functioning after STN-DBS.
DOI: 10.1002/mds.23078
PubMed: 20589868
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Pinsker</name></author><author><name sortKey="Krause, Martin" sort="Krause, Martin" uniqKey="Krause M" first="Martin" last="Krause">Martin Krause</name></author><author><name sortKey="Tronnier, Volker" sort="Tronnier, Volker" uniqKey="Tronnier V" first="Volker" last="Tronnier">Volker Tronnier</name></author><author><name sortKey="Kloss, Manja" sort="Kloss, Manja" uniqKey="Kloss M" first="Manja" last="Kloss">Manja Kloss</name></author><author><name sortKey="Schnitzler, Alfons" sort="Schnitzler, Alfons" uniqKey="Schnitzler A" first="Alfons" last="Schnitzler">Alfons Schnitzler</name></author><author><name sortKey="Wojtecki, Lars" sort="Wojtecki, Lars" uniqKey="Wojtecki L" first="Lars" last="Wojtecki">Lars Wojtecki</name></author><author><name sortKey="Botzel, Kai" sort="Botzel, Kai" uniqKey="Botzel K" first="Kai" last="Bötzel">Kai Bötzel</name></author><author><name sortKey="Danek, Adrian" sort="Danek, Adrian" uniqKey="Danek A" first="Adrian" last="Danek">Adrian Danek</name></author><author><name sortKey="Hilker, Rudiger" sort="Hilker, Rudiger" uniqKey="Hilker R" first="Rüdiger" last="Hilker">Rüdiger Hilker</name></author><author><name sortKey="Sturm, Volker" sort="Sturm, Volker" uniqKey="Sturm V" first="Volker" last="Sturm">Volker Sturm</name></author><author><name sortKey="Kupsch, Andreas" sort="Kupsch, Andreas" uniqKey="Kupsch A" first="Andreas" last="Kupsch">Andreas Kupsch</name></author><author><name sortKey="Karner, Elfriede" sort="Karner, Elfriede" uniqKey="Karner E" first="Elfriede" last="Karner">Elfriede Karner</name></author><author><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name></author><author><name sortKey="Witt, Karsten" sort="Witt, Karsten" uniqKey="Witt K" first="Karsten" last="Witt">Karsten Witt</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="doi">10.1002/mds.23078</idno><idno type="RBID">pubmed:20589868</idno><idno type="pmid">20589868</idno><idno type="wicri:Area/PubMed/Corpus">001788</idno><idno type="wicri:Area/PubMed/Curation">001788</idno><idno type="wicri:Area/PubMed/Checkpoint">001632</idno><idno type="wicri:Area/Ncbi/Merge">002C29</idno><idno type="wicri:Area/Ncbi/Curation">002C29</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease.</title><author><name sortKey="Daniels, Christine" sort="Daniels, Christine" uniqKey="Daniels C" first="Christine" last="Daniels">Christine Daniels</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, Christian-Albrechts-University, Kiel, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Christian-Albrechts-University, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></author><author><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name></author><author><name sortKey="Pinsker, Markus O" sort="Pinsker, Markus O" uniqKey="Pinsker M" first="Markus O" last="Pinsker">Markus O. Pinsker</name></author><author><name sortKey="Krause, Martin" sort="Krause, Martin" uniqKey="Krause M" first="Martin" last="Krause">Martin Krause</name></author><author><name sortKey="Tronnier, Volker" sort="Tronnier, Volker" uniqKey="Tronnier V" first="Volker" last="Tronnier">Volker Tronnier</name></author><author><name sortKey="Kloss, Manja" sort="Kloss, Manja" uniqKey="Kloss M" first="Manja" last="Kloss">Manja Kloss</name></author><author><name sortKey="Schnitzler, Alfons" sort="Schnitzler, Alfons" uniqKey="Schnitzler A" first="Alfons" last="Schnitzler">Alfons Schnitzler</name></author><author><name sortKey="Wojtecki, Lars" sort="Wojtecki, Lars" uniqKey="Wojtecki L" first="Lars" last="Wojtecki">Lars Wojtecki</name></author><author><name sortKey="Botzel, Kai" sort="Botzel, Kai" uniqKey="Botzel K" first="Kai" last="Bötzel">Kai Bötzel</name></author><author><name sortKey="Danek, Adrian" sort="Danek, Adrian" uniqKey="Danek A" first="Adrian" last="Danek">Adrian Danek</name></author><author><name sortKey="Hilker, Rudiger" sort="Hilker, Rudiger" uniqKey="Hilker R" first="Rüdiger" last="Hilker">Rüdiger Hilker</name></author><author><name sortKey="Sturm, Volker" sort="Sturm, Volker" uniqKey="Sturm V" first="Volker" last="Sturm">Volker Sturm</name></author><author><name sortKey="Kupsch, Andreas" sort="Kupsch, Andreas" uniqKey="Kupsch A" first="Andreas" last="Kupsch">Andreas Kupsch</name></author><author><name sortKey="Karner, Elfriede" sort="Karner, Elfriede" uniqKey="Karner E" first="Elfriede" last="Karner">Elfriede Karner</name></author><author><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name></author><author><name sortKey="Witt, Karsten" sort="Witt, Karsten" uniqKey="Witt K" first="Karsten" last="Witt">Karsten Witt</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Cognition Disorders (etiology)</term><term>Deep Brain Stimulation (adverse effects)</term><term>Executive Function (physiology)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Risk Factors</term><term>Statistics as Topic</term><term>Subthalamic Nucleus (physiology)</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cognition Disorders</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Executive Function</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><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>Risk Factors</term><term>Statistics as Topic</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A slight decline in cognitive functions and especially in executive functioning after deep brain stimulation (DBS) of the nucleus subthalamicus (STN) in patients with Parkinson's disease (PD) has been described. This study evaluated baseline parameters that contribute to a deterioration of cognitive functioning after DBS. We analyzed data from the neuropsychological protocol in a randomized controlled study comparing DBS with best medical treatment (BMT). Change scores were calculated for the cognitive domains "global cognitive functioning," "memory," "working memory," "attention," and "executive function." These domain-specific change scores were correlated with previously defined preoperative parameters. Compared with the BMT group (63 patients), the STN-DBS group (60 patients) showed a significant decline only in the domain executive function 6 months after DBS, which was significantly correlated with age, levodopa-equivalence dosage (LED) and axial subscore of the UPDRS in the off-medication state at baseline. Multiple regression analysis showed that these three factors explained, however, only about 23% of the variance. Patients with higher age, higher baseline LED, and/or higher axial subscore of the UPDRS at baseline have an increased risk for worsening of executive function after STN-DBS. High scores of these factors might reflect an advanced stage of disease progression. As these baseline factors explained the variance of the change score executive function only to a minor proportion, other factors including the surgical procedure, the exact placement of the electrode or postsurgical management might be more relevant for a decline in executive functioning after STN-DBS.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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