Cognitive effects of unilateral posteroventral pallidotomy: a 4-year follow-up study.
We assessed the long-term neuropsychological effects of unilateral posteroventral pallidotomy in Parkinson's disease. Eleven Parkinson's disease patients, from an original cohort of 15 consecutive patients who underwent pallidotomy, were evaluated. A neuropsychological battery was administered to each patient before (3 days) and after (3 months and 4 years) surgery during the effects of levodopa. The following tests were administered: Rey's Auditory-Verbal Learning Test, Visual Associative Learning test from the Wechsler Memory Scale-Revised, Luria's motor alternation, Benton's Judgment of Line Orientation, Trail Making, phonetic verbal fluency, Stroop test, Petrides' working memory tasks, Beck's depression questionnaire and the Maudsley obsessional-compulsive inventory. In the 3-month postoperative assessment, there was a significant worsening in phonetic verbal fluency and an improvement in Benton's Judgment of Line Orientation test. In the 4-year follow-up assessment, phonetic verbal fluency and Benton's Judgment of Line Orientation test returned to baseline scores. Although there was no significant difference between pre- and postsurgical scores for long-term visual associative memory, there was a significant deterioration between 3-month and 4-year follow-up performances. Our results suggest that unilateral posteroventral pallidotomy may produce transient changes in prefrontal and visuospatial functions, but there is no evidence of permanent neuropsychological effects.
Alegret
Montse
M
Parkinson's and Movement Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Valldeoriola
Francesc
F
Parkinson's and Movement Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Tolosa
Eduardo
E
Parkinson's and Movement Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Vendrell
Pere
P
Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Junqué
Carme
C
Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Martínez
José
J
Parkinson's and Movement Disorders Unit, Neurology Service, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Rumià
Jordi
J
Neurosurgery Service, Hospital Clinic, Barcelona, Spain.
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000503:physiopathology; D005917:Globus Pallidus / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D013647:Task Performance and Analysis; D013997:Time Factors