Stable cognitive functioning with improved perceptual reasoning in children with dyskinetic cerebral palsy and other secondary dystonias after deep brain stimulation.
BACKGROUND
Dystonia is characterised by involuntary movements (twisting, writhing and jerking) and postures. Secondary dystonias are described as a heterogeneous group of disorders with both exogenous and endogenous causes. There is a growing body of literature on the effects of deep brain stimulation (DBS) surgery on the motor function in childhood secondary dystonias, however research on cognitive function after DBS is scarce.


METHODS
Cognitive function was measured in a cohort of 40 children with secondary dystonia following DBS surgery using a retrospective repeated measures design. Baseline pre-DBS neuropsychological measures were compared to scores obtained at least one year following DBS. Cognitive function was assessed using standardised measures of intellectual ability and memory.


RESULTS
There was no significant change in the assessed domains of cognitive function following DBS surgery. A significant improvement across the group was found on the Picture Completion subtest, measuring perceptual reasoning ability, following DBS.


CONCLUSIONS
Cognition remained stable in children with secondary dystonia following DBS surgery, with some improvements noted in a domain of perceptual reasoning. Further research with a larger sample is necessary to further explore this, in particular to further subdivide this group to account for its heterogeneity. This preliminary data has potentially positive implications for the impact of DBS on cognitive functioning within the childhood secondary dystonia population.
Complex Motor Disorders Service, Paediatric Neurosciences, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Department of Clinical Psychology, Royal Holloway, University of London, UK. Electronic address: tamsin.owen@gstt.nhs.uk.
Tamsin
T
Owen
Complex Motor Disorders Service, Paediatric Neurosciences, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK.
Dolapo
D
Adegboye
Complex Motor Disorders Service, Paediatric Neurosciences, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Department of Psychology, Institute of Psychiatry, King's College London, UK.
Hortensia
H
Gimeno
Functional Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK.
Richard
R
Selway
Complex Motor Disorders Service, Paediatric Neurosciences, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK.
Jean-Pierre
JP
Lin
D000293:Adolescent; D002547:Cerebral Palsy / Q000523:psychology* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000523:psychology* / Q000534:rehabilitation*; D015331:Cohort Studies; D046690:Deep Brain Stimulation / Q000379:methods*; D020821:Dystonic Disorders / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000523:psychology* / Q000534:rehabilitation*; D011340:Problem Solving; D012189:Retrospective Studies; D016896:Treatment Outcome; D014888:Wechsler Scales
Cerebral palsy; Childhood secondary dystonia; Cognition; Deep brain stimulation surgery