Deep brain stimulation of the subthalamic nucleus improves intrinsic alertness in Parkinson's disease.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a treatment option for patients with Parkinson's disease (PD) in the advanced stage. Besides motor improvement, DBS of the STN may also modulate cognitive and attentional functions of the basal ganglia. In our study, 13 patients with PD and bilateral DBS of the STN were assessed with DBS switched on and off by the use of a wide range of neuropsychological tasks. This included reasoning, cognitive flexibility, phonemic and semantic word fluency, verbal and nonverbal short-term memory, learning, delayed verbal memory recall, and stimulus-response incompatibility. Special emphasis was put on basic attentional functions, in particular intrinsic and phasic alertness as well as visual search. DBS significantly improved intrinsic alertness, whereas phasic alertness and other neuropsychological domains were not affected. Additionally, the effects on intrinsic alertness were independent of motor improvements by DBS. The findings suggest that DBS modulates the fronto-parietal network of alertness.
Fimm
Bruno
B
Department of Neurology, University Hospital RWTH Aachen, Germany. fimm@neuropsych.rwth-aachen.de
Heber
Ines A
IA
Coenen
Volker A
VA
Fromm
Christoph
C
Noth
Johannes
J
Kronenbuerger
Martin
M
D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000494:pharmacology / Q000627:therapeutic use; D001288:Attention / Q000187:drug effects / Q000502:physiology*; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008297:Male; D008606:Mental Processes / Q000187:drug effects / Q000502:physiology; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects / Q000502:physiology; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000187:drug effects / Q000503:physiopathology; D010300:Parkinson Disease / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D011597:Psychomotor Performance / Q000187:drug effects / Q000502:physiology; D011897:Random Allocation; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000187:drug effects / Q000503:physiopathology*
D000978:Antiparkinson Agents