Impact of bilateral anterior cingulotomy on neurocognitive function in patients with intractable pain.
Although the cingulate cortices are important with regard to neurocognitive functions, outcome studies usually fail to identify evident cognitive dysfunction following anterior cingulotomy. The aim of this study was to document any impairment of neurocognitive functions following anterior cingulotomy. Between September 2002 and April 2004, 10 patients underwent stereotactic bilateral anterior cingulotomy for intractable cancer pain. A neuropsychological assessment of each patient was performed 1 day prior to surgery and 1 week and 1 month post-operatively. Assessment of pain relief was evaluated with a short form of the McGill pain questionnaire. Six of the 10 patients achieved fair to good pain relief following the cingulotomy procedure. Most neurocognitive functions, including language, memory, motor, visual-constructional, and intellectual functions, remained unaffected. A decline in focused attention performance was identified at the early post-operative assessment. The results of this longitudinal evaluation will help to better define the risk-to-benefit profile of cingulotomy for intractable pain.
Yen
Chun-Po
CP
Department of Neurosurgery, Kaohsiung Medical University, 100 Shih-Chuang 1st Road, Kaohsiung 807, Taiwan.
Kuan
Chu-Yun
CY
Sheehan
Jason
J
Kung
Sui-Sum
SS
Wang
Chin-Chui
CC
Liu
Ching-Kuan
CK
Kwan
Aij Lie
AL
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001288:Attention; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006179:Gyrus Cinguli / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010147:Pain Measurement; D010148:Intractable Pain / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D011340:Problem Solving; D011597:Psychomotor Performance; D012189:Retrospective Studies; D014796:Visual Perception