title: Impact of bilateral subthalamic stimulation on motor/cognitive functions in Parkinson's disease.
abstract: It is still unclear whether deep brain stimulation targeted to the bilateral subthalamic nucleus (STN-DBS) affects cognitive function in Parkinson's disease (PD). This prospective study was aimed to systemically evaluate the impact of bilateral STN-DBS on motor and cognitive functions in patients with PD. This study included totally 11 Japanese patients with medically intolerant PD. Neurological and cognitive status was precisely evaluated before and 1 year after bilateral STN-DBS, using unified Parkinson's disease rating scale (UPDRS), levodopa equivalent doses, mini-mental state examination (MMSE), Japanese adult reading test (JART), repeatable battery for the assessment of neuropsychological status (RBANS), and Wechsler adult intelligence scale-revised (WAIS-R). Preoperative RBANS and WAIS-R identified cognitive dysfunction that could not be detected by MMSE and JART. Before surgery, PD patients had significantly impaired immediate memory and attention. Motor function significantly improved 1 year after bilateral STN-DBS. Bilateral STN-DBS did not affect any score on cognitive examinations. However, postoperative improvements of total score on RBANS and performance intelligence quotient (PIQ) scores on WAIS-R were closely related to those of UPDRS part III off (R(2) = 0.61, P < 0.01; R(2) = 0.39, P < 0.05, respectively). These findings strongly suggest that bilateral STN-DBS may significantly improve cognitive function in a certain subgroup of patients whose therapeutic effects on motor function are prominent.
authors.affiliation: Department of Neurosurgery, Toyama University Hospital.
authors.forename: Takashi
authors.initials: T
authors.lastname: Asahi
authors.forename: Naomi
authors.initials: N
authors.lastname: Nakamichi
authors.forename: Akiko
authors.initials: A
authors.lastname: Takaiwa
authors.forename: Daina
authors.initials: D
authors.lastname: Kashiwazaki
authors.forename: Masaki
authors.initials: M
authors.lastname: Koh
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Dougu
authors.forename: Shutaro
authors.initials: S
authors.lastname: Takashima
authors.forename: Kortaro
authors.initials: K
authors.lastname: Tanaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuroda
mesh_terms: D000328:Adult; D000368:Aged; D003071:Cognition / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000379:methods*; D004292:Dominance, Cerebral / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D011446:Prospective Studies; D020531:Subthalamic Nucleus / Q000503:physiopathology*