Cognition following bilateral deep brain stimulation surgery of the subthalamic nuclear for Parkinson's disease

Casey H. Halpen, Jacqueline H. Rick, Shabbar F. Danish, Murray Grossman, Gordon H. Baltuch

Research output: Contribution to journalReview articlepeer-review

45 Scopus citations

Abstract

Objective: Parkinson's disease (PD) is a neurodegenerative disorder characterized by significant motor dysfunction and various non-motor disturbances, including cognitive alterations. Deep brain stimulation (DBS) is an increasingly utilized therapeutic option for patients with PD that yields remarkable success in alleviating disabling motor symptoms. DBS has additionally been associated with changes in cognition, yet the evidence is not consistent across studies. The following review sought to provide a clearer understanding of the various cognitive sequelae of bilateral subthalamic nucleus (STN) DBS while taking into account corresponding neuroanatomy and potential confounding variables. Design: A literature search was performed using the following inclusion criteria: (1) at least five subjects followed for a mean of at least 3 months after surgery; (2) pre- and postoperative cognitive data using at least one standardized measure; (3) adequate report of study results using means and standard deviations. Results: Two recent meta-analyses found mild post-operative impairments in verbal learning and executive function in patients who underwent DBS surgery. However, studies have revealed improved working memory and psychomotor speed in the 'on' vs 'off' stimulation state. A deficit in language may be a consequence of the surgical procedure. Conclusions: While cognitive decline has been observed in some domains, our review of the data suggests that STN DBS is a worthwhile and safe method to treat PD.

Original languageEnglish (US)
Pages (from-to)443-451
Number of pages9
JournalInternational Journal of Geriatric Psychiatry
Volume24
Issue number5
DOIs
StatePublished - Jul 1 2009
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Keywords

  • Cognition
  • Deep brain stimulation
  • Neuropsychologic
  • Parkinson's disease
  • Subthalamic

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