title: Neuropsychological and psychiatric assessments following bilateral deep brain stimulation of the subthalamic nucleus in Japanese patients with Parkinson's disease.
abstract: The physical benefits of subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) patients are well documented, but the mental benefits are uncertain, particularly in Japanese patients. This study evaluated the clinical and neuropsychological characteristics before and after STN-DBS surgery in Japanese PD patients. PD patients (n=13, age 67.0 ± 7.8 years) were evaluated pre-surgery (baseline) and at 1 and 6 months post-surgery by two trained psychiatrists. The motor symptoms were assessed by the Unified Parkinson's Disease Rating Scale (UPDRS) motor score. The neuropsychological and psychiatric tests performed were the Mini-Mental State Examination, the Wisconsin Card Sorting Test (WCST), the Verbal Fluency Test (VFT), the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale (HAM-A). The UPDRS motor score (p<0.001) and HAM-A score (p=0.004) showed significant improvement at 1 month post-surgery, but a significant decline was observed in the WCST total error (p=0.005) and the semantic VFT score (p<0.001). The phonetic VFT also showed a substantial decline (p=0.015) at 1 month post-surgery. At 6 months post-surgery, the improvement in the UPDRS motor score was maintained, and the scores on the neuropsychological and psychiatric tests had returned to baseline. Although bilateral STN-DBS did not appear to have long-term effects on neuropsychological and psychiatric outcomes, the microlesion effects associated with STN-DBS appear to increase the risk of transient cognitive and psychiatric complications. These complications should be monitored by careful observation of neurological and psychiatric symptoms.
authors.affiliation: Department of Psychiatry, Jounan Hospital, Tokushima, Japan; Department of Psychiatry, Course of Integrated Brain Sciences, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima-shi, Tokushima 770-8503, Japan.
authors.forename: Michitaka
authors.initials: M
authors.lastname: Aono
authors.affiliation: Department of Psychiatry, Course of Integrated Brain Sciences, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima-shi, Tokushima 770-8503, Japan. Electronic address: igajunichi@hotmail.com.
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Iga
authors.affiliation: Department of Neuropsychiatry, Neuroscience, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Shu-Ichi
authors.initials: S
authors.lastname: Ueno
authors.affiliation: Department of Neurosurgery, Naruto Health Insurance Hospital, Tokushima, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Agawa
authors.affiliation: Department of Neurosurgery, Naruto Health Insurance Hospital, Tokushima, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuda
authors.affiliation: Department of Psychiatry, Course of Integrated Brain Sciences, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima-shi, Tokushima 770-8503, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ohmori
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D009043:Motor Activity; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D020531:Subthalamic Nucleus / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Anxiety; Cognitive function; Deep brain stimulation; Parkinson’s disease; Subthalamic nucleus