Impact of bilateral subthalamic stimulation on motor/cognitive functions in Parkinson's disease

Neurol Med Chir (Tokyo). 2014;54(7):529-36. doi: 10.2176/nmc.oa.2013-0364. Epub 2014 May 29.

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.

MeSH terms

  • Adult
  • Aged
  • Cognition / physiology*
  • Deep Brain Stimulation / methods*
  • Dominance, Cerebral / physiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Intelligence / physiology
  • Male
  • Middle Aged
  • Motor Skills / physiology*
  • Neurologic Examination
  • Neuropsychological Tests
  • Parkinson Disease / diagnosis
  • Parkinson Disease / physiopathology*
  • Parkinson Disease / therapy*
  • Prospective Studies
  • Subthalamic Nucleus / physiopathology*