Chronic Electrical Stimulation of the Left Ventrointermediate (Vim) Thalamic Nucleus for the Treatment of Pharmacotherapy-Resistant Parkinson's Disease: A Differential Impact on Access to Semantic and Episodic Memory?
Identifieur interne : 001111 ( Main/Corpus ); précédent : 001110; suivant : 001112Chronic Electrical Stimulation of the Left Ventrointermediate (Vim) Thalamic Nucleus for the Treatment of Pharmacotherapy-Resistant Parkinson's Disease: A Differential Impact on Access to Semantic and Episodic Memory?
Auteurs : Alexander I. Tröster ; Steven B. Wilkinson ; Julie A. Fields ; Karen Miyawaki ; William C. KollerSource :
- Brain and Cognition [ 0278-2626 ] ; 1998.
Abstract
Thalamotomy for medically refractory Parkinson's disease (PD) is considered to be efficacious and relatively safe. Because a minority of patients experience decrements in language and memory (often mild and transient) after thalamotomy, chronic thalamic deep brain stimulation (DBS) might be a safer treatment given its reversibility and the modifiability of stimulation parameters. Two preliminary studies support the relative cognitive safety of unilateral DBS of the ventral intermediate (Vim) thalamic nucleus, but it is unclear whether possibly subtle changes in language and memory represent effects of “microthalamotomy” or of stimulation per se. This report provides preliminary data concerning effects of left thalamic stimulation on information processing speed, semantic memory (verbal fluency and visual confrontation naming), and verbal episodic memory in a patient with PD. In addition to being evaluated before and 3 and 6 months after surgery, the patient was tested 18 months after surgery either on or off medications and with the stimulator turned either on or off (order counterbalanced across medication conditions). Test performance differences between the stimulation conditions were attenuated “off” as compared to “on” medication. Vim stimulation consistently, albeit subtly, improved semantic verbal fluency but interfered with immediate recall of word lists. Parallels to findings from acute, intraoperative thalamic stimulation studies are explored. The hypothesis is offered that left Vim stimulation might facilitate access to semantic memory, but interfere with episodic memory processes.
Url:
DOI: 10.1006/brcg.1998.1025
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Koller</name><affiliation><mods:affiliation>Department of Neurology, University of Kansas Medical Center</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain and Cognition</title><title level="j" type="abbrev">YBRCG</title><idno type="ISSN">0278-2626</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1998">1998</date><biblScope unit="volume">38</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="125">125</biblScope><biblScope unit="page" to="149">149</biblScope></imprint><idno type="ISSN">0278-2626</idno></series><idno type="istex">95B7BC67AF395B93A8FF586C633897C0B92E5412</idno><idno type="DOI">10.1006/brcg.1998.1025</idno><idno type="PII">S0278-2626(98)91025-9</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0278-2626</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Thalamotomy for medically refractory Parkinson's disease (PD) is considered to be efficacious and relatively safe. Because a minority of patients experience decrements in language and memory (often mild and transient) after thalamotomy, chronic thalamic deep brain stimulation (DBS) might be a safer treatment given its reversibility and the modifiability of stimulation parameters. Two preliminary studies support the relative cognitive safety of unilateral DBS of the ventral intermediate (Vim) thalamic nucleus, but it is unclear whether possibly subtle changes in language and memory represent effects of “microthalamotomy” or of stimulation per se. This report provides preliminary data concerning effects of left thalamic stimulation on information processing speed, semantic memory (verbal fluency and visual confrontation naming), and verbal episodic memory in a patient with PD. In addition to being evaluated before and 3 and 6 months after surgery, the patient was tested 18 months after surgery either on or off medications and with the stimulator turned either on or off (order counterbalanced across medication conditions). Test performance differences between the stimulation conditions were attenuated “off” as compared to “on” medication. Vim stimulation consistently, albeit subtly, improved semantic verbal fluency but interfered with immediate recall of word lists. Parallels to findings from acute, intraoperative thalamic stimulation studies are explored. The hypothesis is offered that left Vim stimulation might facilitate access to semantic memory, but interfere with episodic memory processes.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Alexander I. 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This report provides preliminary data concerning effects of left thalamic stimulation on information processing speed, semantic memory (verbal fluency and visual confrontation naming), and verbal episodic memory in a patient with PD. In addition to being evaluated before and 3 and 6 months after surgery, the patient was tested 18 months after surgery either on or off medications and with the stimulator turned either on or off (order counterbalanced across medication conditions). Test performance differences between the stimulation conditions were attenuated “off” as compared to “on” medication. Vim stimulation consistently, albeit subtly, improved semantic verbal fluency but interfered with immediate recall of word lists. Parallels to findings from acute, intraoperative thalamic stimulation studies are explored. 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Whitaker for discussing this case and for suggesting postsurgical cognitive evaluation with the stimulator on and off.</note><note>Address correspondence and reprint requests to Alexander I. Tröster, Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160-7314. Fax: (913) 588-6965. E-mail:atroster@kumc.edu.</note><note>P. L. GildenbergR. R. 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In addition to being evaluated before and 3 and 6 months after surgery, the patient was tested 18 months after surgery either on or off medications and with the stimulator turned either on or off (order counterbalanced across medication conditions). Test performance differences between the stimulation conditions were attenuated “off” as compared to “on” medication. Vim stimulation consistently, albeit subtly, improved semantic verbal fluency but interfered with immediate recall of word lists. Parallels to findings from acute, intraoperative thalamic stimulation studies are explored. 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Whitaker for discussing this case and for suggesting postsurgical cognitive evaluation with the stimulator on and off.</ce:note-para><ce:note-para>Address correspondence and reprint requests to Alexander I. Tröster, Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160-7314. Fax: (913) 588-6965. E-mail:atroster@kumc.edu.</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>☆☆</ce:label><ce:note-para>P. L. GildenbergR. R. Tasker</ce:note-para></ce:article-footnote><ce:dochead><ce:textfn>Regular Article</ce:textfn></ce:dochead><ce:title>Chronic Electrical Stimulation of the Left Ventrointermediate (Vim) Thalamic Nucleus for the Treatment of Pharmacotherapy-Resistant Parkinson's Disease: A Differential Impact on Access to Semantic and Episodic Memory?</ce:title><ce:author-group><ce:author><ce:given-name>Alexander I.</ce:given-name><ce:surname>Tröster</ce:surname><ce:cross-ref refid="BR981025A1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Steven B.</ce:given-name><ce:surname>Wilkinson</ce:surname><ce:cross-ref refid="BR981025A2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Julie A.</ce:given-name><ce:surname>Fields</ce:surname><ce:cross-ref refid="BR981025A3"><ce:sup>c</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Karen</ce:given-name><ce:surname>Miyawaki</ce:surname><ce:cross-ref refid="BR981025A4"><ce:sup>d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>William C.</ce:given-name><ce:surname>Koller</ce:surname><ce:cross-ref refid="BR981025A4"><ce:sup>d</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="BR981025A1"><ce:label>a</ce:label><ce:textfn>Department of Neurology, University of Kansas Medical Center and Center for Neuropsychology and Cognitive Neuroscience, University of Kansas Hospital</ce:textfn></ce:affiliation><ce:affiliation id="BR981025A2"><ce:label>b</ce:label><ce:textfn>Division of Neurological Surgery, University of Kansas Medical Center</ce:textfn></ce:affiliation><ce:affiliation id="BR981025A3"><ce:label>c</ce:label><ce:textfn>Center for Neuropsychology and Cognitive Neuroscience, University of Kansas Hospital</ce:textfn></ce:affiliation><ce:affiliation id="BR981025A4"><ce:label>d</ce:label><ce:textfn>Department of Neurology, University of Kansas Medical Center</ce:textfn></ce:affiliation></ce:author-group><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>Thalamotomy for medically refractory Parkinson's disease (PD) is considered to be efficacious and relatively safe. 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In addition to being evaluated before and 3 and 6 months after surgery, the patient was tested 18 months after surgery either on or off medications and with the stimulator turned either on or off (order counterbalanced across medication conditions). Test performance differences between the stimulation conditions were attenuated “off” as compared to “on” medication. Vim stimulation consistently, albeit subtly, improved semantic verbal fluency but interfered with immediate recall of word lists. Parallels to findings from acute, intraoperative thalamic stimulation studies are explored. 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Because a minority of patients experience decrements in language and memory (often mild and transient) after thalamotomy, chronic thalamic deep brain stimulation (DBS) might be a safer treatment given its reversibility and the modifiability of stimulation parameters. Two preliminary studies support the relative cognitive safety of unilateral DBS of the ventral intermediate (Vim) thalamic nucleus, but it is unclear whether possibly subtle changes in language and memory represent effects of “microthalamotomy” or of stimulation per se. This report provides preliminary data concerning effects of left thalamic stimulation on information processing speed, semantic memory (verbal fluency and visual confrontation naming), and verbal episodic memory in a patient with PD. In addition to being evaluated before and 3 and 6 months after surgery, the patient was tested 18 months after surgery either on or off medications and with the stimulator turned either on or off (order counterbalanced across medication conditions). Test performance differences between the stimulation conditions were attenuated “off” as compared to “on” medication. Vim stimulation consistently, albeit subtly, improved semantic verbal fluency but interfered with immediate recall of word lists. Parallels to findings from acute, intraoperative thalamic stimulation studies are explored. The hypothesis is offered that left Vim stimulation might facilitate access to semantic memory, but interfere with episodic memory processes.</abstract><note>The authors thank Dr. Harry A. Whitaker for discussing this case and for suggesting postsurgical cognitive evaluation with the stimulator on and off.</note><note>Address correspondence and reprint requests to Alexander I. 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