Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease
Identifieur interne : 000448 ( Main/Corpus ); précédent : 000447; suivant : 000449Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease
Auteurs : Christine Daniels ; 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 [ 0885-3185 ] ; 2010-08-15.
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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. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23078
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first="Elfriede" last="Karner">Elfriede Karner</name><affiliation><mods:affiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</mods:affiliation></affiliation></author><author><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Witt, Karsten" sort="Witt, Karsten" uniqKey="Witt K" first="Karsten" last="Witt">Karsten Witt</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:93BD43D9A68C911E46F438EAA53F9605C4BC45CC</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1002/mds.23078</idno><idno 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last="Volkmann">Jens Volkmann</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Pinsker, Markus O" sort="Pinsker, Markus O" uniqKey="Pinsker M" first="Markus O." last="Pinsker">Markus O. Pinsker</name><affiliation><mods:affiliation>Department of Neurosurgery, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Krause, Martin" sort="Krause, Martin" uniqKey="Krause M" first="Martin" last="Krause">Martin Krause</name><affiliation><mods:affiliation>Department of Neurology, Heidelberg University, Heidelberg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Tronnier, Volker" sort="Tronnier, Volker" uniqKey="Tronnier V" first="Volker" last="Tronnier">Volker Tronnier</name><affiliation><mods:affiliation>Department of Neurosurgery, Heidelberg University, Heidelberg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kloss, Manja" sort="Kloss, Manja" uniqKey="Kloss M" first="Manja" last="Kloss">Manja Kloss</name><affiliation><mods:affiliation>Department of Neurology, Heidelberg University, Heidelberg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Schnitzler, Alfons" sort="Schnitzler, Alfons" uniqKey="Schnitzler A" first="Alfons" last="Schnitzler">Alfons Schnitzler</name><affiliation><mods:affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wojtecki, Lars" sort="Wojtecki, Lars" uniqKey="Wojtecki L" first="Lars" last="Wojtecki">Lars Wojtecki</name><affiliation><mods:affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</mods:affiliation></affiliation></author><author><name sortKey="Botzel, Kai" sort="Botzel, Kai" uniqKey="Botzel K" first="Kai" last="Bötzel">Kai Bötzel</name><affiliation><mods:affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</mods:affiliation></affiliation></author><author><name sortKey="Danek, Adrian" sort="Danek, Adrian" uniqKey="Danek A" first="Adrian" last="Danek">Adrian Danek</name><affiliation><mods:affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hilker, Rudiger" sort="Hilker, Rudiger" uniqKey="Hilker R" first="Rüdiger" last="Hilker">Rüdiger Hilker</name><affiliation><mods:affiliation>Department of Neurology, Cologne University, Cologne, Germany</mods:affiliation></affiliation></author><author><name sortKey="Sturm, Volker" sort="Sturm, Volker" uniqKey="Sturm V" first="Volker" last="Sturm">Volker Sturm</name><affiliation><mods:affiliation>Department of Neurosurgery, Cologne University, Cologne, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kupsch, Andreas" sort="Kupsch, Andreas" uniqKey="Kupsch A" first="Andreas" last="Kupsch">Andreas Kupsch</name><affiliation><mods:affiliation>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</mods:affiliation></affiliation></author><author><name sortKey="Karner, Elfriede" sort="Karner, Elfriede" uniqKey="Karner E" first="Elfriede" last="Karner">Elfriede Karner</name><affiliation><mods:affiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</mods:affiliation></affiliation></author><author><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Witt, Karsten" sort="Witt, Karsten" uniqKey="Witt K" first="Karsten" last="Witt">Karsten Witt</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-08-15">2010-08-15</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1583">1583</biblScope><biblScope unit="page" to="1589">1589</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">93BD43D9A68C911E46F438EAA53F9605C4BC45CC</idno><idno type="DOI">10.1002/mds.23078</idno><idno type="ArticleID">MDS23078</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>deep brain stimulation</term><term>executive functions</term><term>subthalamic nucleus</term><term>verbal fluency</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></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. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Christine Daniels MD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Paul Krack MD, PhD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Jens Volkmann MD, PhD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Markus O. Pinsker MD, PhD</name><affiliations><json:string>Department of Neurosurgery, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Martin Krause MD, PhD</name><affiliations><json:string>Department of Neurology, Heidelberg University, Heidelberg, Germany</json:string></affiliations></json:item><json:item><name>Volker Tronnier MD, PhD</name><affiliations><json:string>Department of Neurosurgery, Heidelberg University, Heidelberg, Germany</json:string></affiliations></json:item><json:item><name>Manja Kloss MD</name><affiliations><json:string>Department of Neurology, Heidelberg University, Heidelberg, Germany</json:string></affiliations></json:item><json:item><name>Alfons Schnitzler MD, PhD</name><affiliations><json:string>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</json:string></affiliations></json:item><json:item><name>Lars Wojtecki MD</name><affiliations><json:string>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</json:string></affiliations></json:item><json:item><name>Kai Bötzel MD, PhD</name><affiliations><json:string>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</json:string></affiliations></json:item><json:item><name>Adrian Danek MD, PhD</name><affiliations><json:string>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</json:string></affiliations></json:item><json:item><name>Rüdiger Hilker MD, PhD</name><affiliations><json:string>Department of Neurology, Cologne University, Cologne, Germany</json:string></affiliations></json:item><json:item><name>Volker Sturm MD, PhD</name><affiliations><json:string>Department of Neurosurgery, Cologne University, Cologne, Germany</json:string></affiliations></json:item><json:item><name>Andreas Kupsch MD, PhD</name><affiliations><json:string>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</json:string></affiliations></json:item><json:item><name>Elfriede Karner MPsych</name><affiliations><json:string>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Günther Deuschl MD, PhD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Karsten Witt MD, PhD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>deep brain stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>subthalamic nucleus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>executive functions</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>verbal fluency</value></json:item></subject><articleId><json:string>MDS23078</json:string></articleId><language><json:string>eng</json:string></language><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. © 2010 Movement Disorder Society</abstract><qualityIndicators><score>7.165</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1740</abstractCharCount><pdfWordCount>4213</pdfWordCount><pdfCharCount>29005</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>246</abstractWordCount></qualityIndicators><title>Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>25</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>7</total><last>1589</last><first>1583</first></pages><issn><json:string>0885-3185</json:string></issn><issue>11</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1002/mds.23078</json:string></doi><id>93BD43D9A68C911E46F438EAA53F9605C4BC45CC</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/93BD43D9A68C911E46F438EAA53F9605C4BC45CC/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/93BD43D9A68C911E46F438EAA53F9605C4BC45CC/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/93BD43D9A68C911E46F438EAA53F9605C4BC45CC/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2010</date></publicationStmt><notesStmt><note>Parkinson Foundation Europe</note><note>German Ministry of Research and Technology - No. FK: 01GI0201;</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease</title><author><persName><forename type="first">Christine</forename><surname>Daniels</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Paul</forename><surname>Krack</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Jens</forename><surname>Volkmann</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Markus O.</forename><surname>Pinsker</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurosurgery, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Martin</forename><surname>Krause</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurology, Heidelberg University, Heidelberg, Germany</affiliation></author><author><persName><forename type="first">Volker</forename><surname>Tronnier</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurosurgery, Heidelberg University, Heidelberg, Germany</affiliation></author><author><persName><forename type="first">Manja</forename><surname>Kloss</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, Heidelberg University, Heidelberg, Germany</affiliation></author><author><persName><forename type="first">Alfons</forename><surname>Schnitzler</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</affiliation></author><author><persName><forename type="first">Lars</forename><surname>Wojtecki</surname></persName><roleName type="degree">MD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</affiliation></author><author><persName><forename type="first">Kai</forename><surname>Bötzel</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</affiliation></author><author><persName><forename type="first">Adrian</forename><surname>Danek</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</affiliation></author><author><persName><forename type="first">Rüdiger</forename><surname>Hilker</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Cologne University, Cologne, Germany</affiliation></author><author><persName><forename type="first">Volker</forename><surname>Sturm</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurosurgery, Cologne University, Cologne, Germany</affiliation></author><author><persName><forename type="first">Andreas</forename><surname>Kupsch</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</affiliation></author><author><persName><forename type="first">Elfriede</forename><surname>Karner</surname></persName><roleName type="degree">MPsych</roleName><affiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Günther</forename><surname>Deuschl</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><affiliation>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</affiliation><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Karsten</forename><surname>Witt</surname></persName><roleName type="degree">MD, PhD</roleName><note type="correspondence"><p>Correspondence: Department of Neurology, University of Schleswig‐Holstein, Campus Kiel, Schittenhelmstrasse 10, D‐24105 Kiel, Germany</p></note><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-08-15"></date><biblScope unit="volume">25</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1583">1583</biblScope><biblScope unit="page" to="1589">1589</biblScope></imprint></monogr><idno type="istex">93BD43D9A68C911E46F438EAA53F9605C4BC45CC</idno><idno type="DOI">10.1002/mds.23078</idno><idno type="ArticleID">MDS23078</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>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. © 2010 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>deep brain stimulation</term></item><item><term>subthalamic nucleus</term></item><item><term>executive functions</term></item><item><term>verbal fluency</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-06-03">Received</change><change when="2010-02-10">Registration</change><change when="2010-08-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/93BD43D9A68C911E46F438EAA53F9605C4BC45CC/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="110"><doi origin="wiley" registered="yes">10.1002/mds.v25:11</doi><numberingGroup><numbering type="journalVolume" number="25">25</numbering><numbering type="journalIssue">11</numbering></numberingGroup><coverDate startDate="2010-08-15">15 August 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="80" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23078</doi><idGroup><id type="unit" value="MDS23078"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2009-06-03"></event><event type="manuscriptRevised" date="2009-12-13"></event><event type="manuscriptAccepted" date="2010-02-10"></event><event type="firstOnline" date="2010-06-29"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-06-29"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.4.7 mode:FullText source:FullText result:FullText" date="2011-02-24"></event><event type="publishedOnlineFinalForm" date="2010-08-18"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">1583</numbering><numbering type="pageLast">1589</numbering></numberingGroup><correspondenceTo>Department of Neurology, University of Schleswig‐Holstein, Campus Kiel, Schittenhelmstrasse 10, D‐24105 Kiel, Germany</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23078.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="35"></count><count type="wordTotal" number="6061"></count></countGroup><titleGroup><title type="main" xml:lang="en">Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease</title><title type="short" xml:lang="en">Executive Functions After DBS in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Christine</givenNames><familyName>Daniels</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1" noteRef="#fn1"><personName><givenNames>Paul</givenNames><familyName>Krack</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1" noteRef="#fn1"><personName><givenNames>Jens</givenNames><familyName>Volkmann</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af2" noteRef="#fn1"><personName><givenNames>Markus O.</givenNames><familyName>Pinsker</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af3" noteRef="#fn1"><personName><givenNames>Martin</givenNames><familyName>Krause</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af4" noteRef="#fn1"><personName><givenNames>Volker</givenNames><familyName>Tronnier</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Manja</givenNames><familyName>Kloss</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af5" noteRef="#fn1"><personName><givenNames>Alfons</givenNames><familyName>Schnitzler</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af5" noteRef="#fn1"><personName><givenNames>Lars</givenNames><familyName>Wojtecki</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af6" noteRef="#fn1"><personName><givenNames>Kai</givenNames><familyName>Bötzel</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af6"><personName><givenNames>Adrian</givenNames><familyName>Danek</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au12" creatorRole="author" affiliationRef="#af7"><personName><givenNames>Rüdiger</givenNames><familyName>Hilker</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au13" creatorRole="author" affiliationRef="#af8" noteRef="#fn1"><personName><givenNames>Volker</givenNames><familyName>Sturm</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au14" creatorRole="author" affiliationRef="#af9" noteRef="#fn1"><personName><givenNames>Andreas</givenNames><familyName>Kupsch</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au15" creatorRole="author" affiliationRef="#af10"><personName><givenNames>Elfriede</givenNames><familyName>Karner</familyName><degrees>MPsych</degrees></personName></creator><creator xml:id="au16" creatorRole="author" affiliationRef="#af1" noteRef="#fn1"><personName><givenNames>Günther</givenNames><familyName>Deuschl</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au17" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Karsten</givenNames><familyName>Witt</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email normalForm="k.witt@neurologie.uni-kiel.de">k.witt@neurologie.uni‐kiel.de</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurosurgery, Christian‐Albrechts‐University, Kiel, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Heidelberg University, Heidelberg, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurosurgery, Heidelberg University, Heidelberg, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Cologne University, Cologne, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af8" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurosurgery, Cologne University, Cologne, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af9" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af10" countryCode="AT" type="organization"><unparsedAffiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">deep brain stimulation</keyword><keyword xml:id="kwd3">subthalamic nucleus</keyword><keyword xml:id="kwd4">executive functions</keyword><keyword xml:id="kwd5">verbal fluency</keyword></keywordGroup><fundingInfo><fundingAgency>Parkinson Foundation Europe</fundingAgency></fundingInfo><fundingInfo><fundingAgency>German Ministry of Research and Technology</fundingAgency><fundingNumber>FK: 01GI0201</fundingNumber></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>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. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Executive Functions After DBS in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Christine</namePart><namePart type="family">Daniels</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Paul</namePart><namePart type="family">Krack</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jens</namePart><namePart type="family">Volkmann</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Markus O.</namePart><namePart type="family">Pinsker</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurosurgery, Christian‐Albrechts‐University, Kiel, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Martin</namePart><namePart type="family">Krause</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Heidelberg University, Heidelberg, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Volker</namePart><namePart type="family">Tronnier</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurosurgery, Heidelberg University, Heidelberg, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Manja</namePart><namePart type="family">Kloss</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Heidelberg University, Heidelberg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alfons</namePart><namePart type="family">Schnitzler</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lars</namePart><namePart type="family">Wojtecki</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kai</namePart><namePart type="family">Bötzel</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Adrian</namePart><namePart type="family">Danek</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rüdiger</namePart><namePart type="family">Hilker</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Cologne University, Cologne, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Volker</namePart><namePart type="family">Sturm</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurosurgery, Cologne University, Cologne, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andreas</namePart><namePart type="family">Kupsch</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elfriede</namePart><namePart type="family">Karner</namePart><namePart type="termsOfAddress">MPsych</namePart><affiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Günther</namePart><namePart type="family">Deuschl</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation><description>Potential conflict of interest: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karsten</namePart><namePart type="family">Witt</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation><description>Correspondence: Department of Neurology, University of Schleswig‐Holstein, Campus Kiel, Schittenhelmstrasse 10, D‐24105 Kiel, Germany</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-08-15</dateIssued><dateCaptured encoding="w3cdtf">2009-06-03</dateCaptured><dateValid encoding="w3cdtf">2010-02-10</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">2</extent><extent unit="references">35</extent><extent unit="words">6061</extent></physicalDescription><abstract 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. © 2010 Movement Disorder Society</abstract><note type="funding">Parkinson Foundation Europe</note><note type="funding">German Ministry of Research and Technology - No. FK: 01GI0201; </note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>deep brain stimulation</topic><topic>subthalamic nucleus</topic><topic>executive functions</topic><topic>verbal fluency</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>25</number></detail><detail type="issue"><caption>no.</caption><number>11</number></detail><extent unit="pages"><start>1583</start><end>1589</end><total>7</total></extent></part></relatedItem><identifier type="istex">93BD43D9A68C911E46F438EAA53F9605C4BC45CC</identifier><identifier type="DOI">10.1002/mds.23078</identifier><identifier type="ArticleID">MDS23078</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2010 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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