Neuropsychological assessment for management of patients with deep brain stimulation.
The inclusion of cognitive and behavioural criteria has been recommended for the management of patients with deep brain stimulation. A neuropsychological assessment may contribute to different issues: (1) selection of the best candidates for surgery, (2) evaluation of the consequences of surgery, (3) research of the best electrode implantation. Recent neuropsychological studies indicate that (1) with appropriate inclusion criteria, the effects of surgery on cognitive functions are limited; (2) an aggravation of behavioural disorders might be related to subthalamic nucleus (STN) stimulation and depend on electrode location; (3) subthalamic nucleus stimulation, but not the internal globus pallidus stimulation, improves psychomotor efficiency and working memory. These results would suggest that the implanted electrodes are not solely targeting the motor circuit and that the cognitive and motor circuits are not completely segregated.
Pillon
Bernard
B
Institut National de la Santé et de la Recherche Médicale E 007 and Assistance Publique, Centre de Neuropsychologie, Fédération de Neurologie, Hôpital de la Salpêtrière, Paris, France. bernard.pillon@psl.ap-hop-paris.fr
D001479:Basal Ganglia / Q000601:surgery; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D004599:Electric Stimulation Therapy / Q000009:adverse effects* / Q000379:methods*; D004567:Electrodes, Implanted; D006801:Humans; D009069:Movement Disorders / Q000601:surgery / Q000628:therapy*; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000601:surgery / Q000628:therapy; D020531:Subthalamic Nucleus / Q000601:surgery; D016896:Treatment Outcome