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Randomized Controlled Trial
. 2017 Mar;32(3):433-440.
doi: 10.1002/mds.26827. Epub 2016 Oct 18.

Neuropsychological outcomes from constant current deep brain stimulation for Parkinson's disease

Alexander I Tröster  1 , Joseph Jankovic  2 , Michele Tagliati  3 , DeLea Peichel  4 , Michael S Okun  5
Affiliations
Randomized Controlled Trial

Neuropsychological outcomes from constant current deep brain stimulation for Parkinson's disease

Alexander I Tröster et al. Mov Disord. 2017 Mar.

Abstract

Objective: The aim of this study was to evaluate the neurobehavioral safety of constant-current subthalamic deep brain stimulation and to compare the neuropsychological effects of stimulation versus electrode placement alone.

Methods: A total of 136 patients with Parkinson's disease underwent bilateral subthalamic device implantation in this randomized trial. Patients received stimulation either immediately after device implantation (n = 101; active stimulation) or beginning 3 months after surgery (n = 35; delayed activation control). Patients were administered neuropsychological tests before, 3, and 12 months after device implantation.

Results: Neuropsychological change in stimulation and control groups were comparable. Within-group analyses revealed declines in category and switching verbal fluency in both groups, but only the stimulation group had letter verbal fluency and Stroop task declines. Depression symptom improvements occurred in both groups, but more often in the stimulation group. Letter fluency declines were associated with worse Parkinson's Disease Questionnaire Communication subscale scores. Baseline and 12-month comparisons (in the combined group) revealed gains in verbal and visual delayed recall scores and improvement in depression symptoms, but decrements in verbal fluency and Stroop scores.

Conclusions: Constant-current bilateral subthalamic stimulation had a good cognitive safety profile except for decrements in verbal fluency and on the Stroop task. These abnormalities are related to device implantation, but stimulation likely had an additive effect. One year after surgery, the cognitive changes did not exert a detrimental effect on quality of life, although letter fluency declines were associated with communication dissatisfaction at 12 months. Improvement in depressive symptom severity appears dependent on stimulation and not placebo or lesion effects. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Keywords: deep brain stimulation; neuropsychological outcomes; parkinson's disease; somatosensory temporal discrimination.

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Figures

Figure 1
Figure 1
Mean change in verbal fluency in active stimulation and control groups at 3 months.
Figure 2
Figure 2
Verbal fluency: frequencies of individual change expressed in standard deviations at 3 months. SD, standard deviation.
Figure 3
Figure 3
Verbal fluency at baseline and 12 months.
See this image and copyright information in PMC

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References

    1. Deuschl G, Schade‐Brittinger C, Krack P, et al. A randomized trial of deep‐brain stimulation for Parkinson's disease. N Engl J Med 2006;355(9):896–908. - PubMed
    1. Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA 2009;301(1):63–73. - PMC - PubMed
    1. Williams A, Gill S, Varma T, et al. Deep brain stimulation plus best medical therapy versus best medical therapy alone for advanced Parkinson's disease (PD SURG trial): a randomised, open‐label trial. Lancet Neurol 2010;9(6):581–591. - PMC - PubMed
    1. Schuepbach WM, Rau J, Knudsen K, et al. Neurostimulation for Parkinson's disease with early motor complications. N Engl J Med 2013;368(7):610–622. - PubMed
    1. Okun MS, Gallo BV, Mandybur G, et al. Subthalamic deep brain stimulation with a constant‐current device in Parkinson's disease: an open‐label randomised controlled trial. Lancet Neurol 2012;11(2):140–149. - PubMed

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