Cognitive functioning after subthalamic nucleotomy for refractory Parkinson's disease.
OBJECTIVE
To evaluate whether subthalamic nucleotomy produces adverse cognitive effects in patients with Parkinson's disease.


METHODS
Twelve patients with Parkinson's disease underwent stereotactic surgery to the subthalamic nucleus. Presurgical and postsurgical neuropsychological assessment of attention, memory, executive function, language, and verbal intellect were undertaken with a battery of tests designed to minimise potential contamination of cognitive effects by motor symptoms.


RESULTS
There was no statistically significant difference in the cognitive tests results after operation for the group as a whole. Reliable change indexes were generated for the cognitive tests. Reliable change postoperatively was found on specific tests of verbal memory, attention, and planning. Left sided operations were associated with greater incidence of deterioration postsurgery.


CONCLUSIONS
Preliminary data on the first reported cognitive changes after subthalamic nucleotomy suggested few adverse cognitive effects of the surgery although discrete neuropsychological changes were seen in some patients. These effects were consistent with current theories on the cognitive functions of the basal ganglia.
McCarter
R J
RJ
Department of Neuropsychology, Frenchay Hospital, Bristol, UK.
Walton
N H
NH
Rowan
A F
AF
Gill
S S
SS
Palomo
M
M
D000328:Adult; D000368:Aged; D001288:Attention / Q000502:physiology; D001931:Brain Mapping; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D011597:Psychomotor Performance / Q000502:physiology; D020531:Subthalamic Nucleus / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome