Neuropsychological effects of bilateral STN stimulation in Parkinson disease: a controlled study.
OBJECTIVE
To evaluate the cognitive and behavioral effects of bilateral subthalamic nucleus (STN) stimulation in patients with Parkinson disease (PD).


METHODS
The authors included 103 patients; 99 patients were evaluated 6 months after surgery. A control group of 39 patients with PD was formed and 36 patients were evaluated 6 months later. At baseline and at follow-up we administered neuropsychological tests of language, memory, visuospatial function, mental speed, and executive functions. A depression rating scale, a quality of life scale, self and proxy ratings of memory and dysexecutive symptoms, and a neuropsychiatric interview were also administered.


RESULTS
Six months after surgery, the STN group showed a larger decline than the control group on measures of verbal fluency, color naming, selective attention, and verbal memory. Moreover, the STN group showed a decrease in positive affect, and an increase in emotional lability and cognitive complaints. On the other hand, the STN group showed an increase in quality of life and a slight decrease in depressive symptoms. Nine percent of the STN patients had psychiatric complications (vs 3% of controls).


CONCLUSIONS
Bilateral subthalamic nucleus stimulation has an adverse effect on executive functions with implications for daily life of the patients and their relatives.
Smeding
H M M
HM
Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands. h.m.smeding@amc.uva.nl
Speelman
J D
JD
Koning-Haanstra
M
M
Schuurman
P R
PR
Nijssen
P
P
van Laar
T
T
Schmand
B
B
D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D046690:Deep Brain Stimulation / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D011788:Quality of Life; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D020531:Subthalamic Nucleus; D016896:Treatment Outcome