Neuropsychological outcome following pallidotomy and thalamotomy for Parkinson's disease.
Cognitive and emotional outcomes were assessed after unilateral posteroventral pallidotomy (PVP) and ventral intermediate nucleus thalamotomy (Vim-Th) in patients suffering from idiopathic Parkinson's disease (PD). PVP was performed on 12 PD patients (8 men and 4 women, mean age 56.4 years, 6 left lesions and 6 right lesions) and Vim-Th was performed on 13 PD patients (5 men and 8 women, mean age 63.2 years, 6 left lesions and 7 right lesions). In both the PVP group and the Vim-Th group, the Hoehn and Yahr staging scores (p < 0.01) and the Unified Parkinson's Disease Rating Scale activities of daily living and motor scores (p < 0.001) improved significantly. No significant changes in cognitive function were observed 4 weeks after unilateral PVP or Vim-Th. PVP produced a significant decline in Hasegawa's Dementia Scale-Revised scores in immediate postoperative assessments (p < 0.05), which resolved 4 weeks after surgery. While the Minnesota Multiphasic Personality Inventory depression and social introversion scores improved significantly in the Vim-Th group (p < 0.01 and p < 0.05, respectively), the hypochondriasis and hypomania scores improved significantly in the PVP group (p < 0.01 and p < 0.05, respectively). We conclude that PVP and Vim-Th influence postoperative emotional status rather than postoperative cognitive status.
Fukuda
M
M
Department of Neurosurgery, National Nishi-Niigata-Chuo Hospital, Niigata University, Niigata, Japan.
Kameyama
S
S
Yoshino
M
M
Tanaka
R
R
Narabayashi
H
H
D000328:Adult; D000339:Affect; D000368:Aged; D003071:Cognition; D003704:Dementia / Q000209:etiology; D003863:Depression / Q000209:etiology; D004292:Dominance, Cerebral; D004525:Efferent Pathways / Q000601:surgery; D004644:Emotions; D005260:Female; D005917:Globus Pallidus / Q000601:surgery*; D006801:Humans; D006998:Hypochondriasis / Q000209:etiology; D007439:Introversion, Psychological; D008950:MMPI; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures; D010300:Parkinson Disease / Q000523:psychology / Q000601:surgery*; D011184:Postoperative Period; D012720:Severity of Illness Index; D013238:Stereotaxic Techniques; D013787:Thalamic Nuclei / Q000601:surgery*; D016896:Treatment Outcome