Neuropsychological changes following deep brain stimulation surgery for Parkinson's disease: comparisons of treatment at pallidal and subthalamic targets versus best medical therapy

摘要: Background Deep brain stimulation (DBS) improves motor symptoms in Parkinson9s disease (PD), but questions remain regarding neuropsychological decrements sometimes associated with this treatment, including rates of statistically and clinically meaningful change, whether there are differences outcome related to surgical target. Methods Neuropsychological functioning was assessed patients (PD) at baseline after 6 months a prospective, randomised, controlled study comparing best medical therapy (BMT, n=116) bilateral deep (DBS, n=164) either the subthalamic nucleus (STN, n=84) or globus pallidus interna (GPi, n=80), using standardised tests. Measures functional outcomes were also administered. Results Comparison two DBS targets revealed few significant group differences. STN greater mean reductions on some measures processing speed, only one which comparison GPi. GPi lower performance measure learning memory that requires mental control cognitive flexibility. Compared receiving BMT, combined had significantly 6-month follow-up multiple speed working memory. After calculating thresholds for reliable change from data obtained BMT group, displayed higher decline test performance. Among completers, 18 (11%) participants by indicators more domains, rate than (3%). This multi-domain less beneficial subjective ratings everyday quality life (QOL). The continued function level 24-month follow-up. Conclusions In those PD, likelihood increases DBS, affecting small minority who appear respond optimally other QOL. Trial registration number NCT00056563 NCT01076452.