Unilateral pallidotomy in PD: a controlled study of cognitive and behavioral effects. The Netherlands Pallidotomy Study (NEPAS) group.
OBJECTIVE
To investigate whether unilateral pallidotomy affects cognitive and behavioral functioning.


METHODS
At baseline and after 6 months we assessed neuropsychological functioning in 35 patients with advanced PD. After baseline examination, patients were randomized to pallidotomy within 1 month (6 left-sided, 13 right-sided) or to pallidotomy after follow-up assessment 6 months later (n = 16; control group). We performed neuropsychological tests of language, visuospatial function, memory, attention, and executive functions. Self ratings and proxy ratings of memory problems and dysexecutive symptoms were also collected.


RESULTS
No significant differences over time were found between pallidotomy and control groups, with the exception of a decrease of verbal fluency in the left-sided pallidotomy group.


CONCLUSIONS
Unilateral pallidotomy is relatively safe with respect to cognition and behavior. Left-sided pallidotomy may lead to minor deterioration in verbal fluency. The sample size of this study is too small, however, to rule out the possibility of infrequent but clinically important side effects.
Schmand
B
B
Academic Medical Center, Department of Neurology, University of Amsterdam, The Netherlands. b.schmand@amc.uva.nl
de Bie
R M
RM
Koning-Haanstra
M
M
de Smet
J S
JS
Speelman
J D
JD
van Zomeren
A H
AH
D000368:Aged; D005260:Female; D007839:Functional Laterality; D005917:Globus Pallidus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D010300:Parkinson Disease / Q000523:psychology* / Q000601:surgery*