Cognitive functioning after pallidotomy for refractory Parkinson’s disease
BACKGROUND Earlier approaches to pallidotomy for refractory Parkinson’s disease had significant complication rates. More recent approaches show fewer complications, but the effect of pallidotomy on cognition is unclear. The current study was conducted to examine the neuropsychological effects of uni...
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| Veröffentlicht in: | Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1998-08, Vol.65 (2), p.150-154 |
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| container_title | Journal of neurology, neurosurgery and psychiatry |
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| creator | Perrine, Kenneth Dogali, Michael Fazzini, Enrico Sterio, Djorje Kolodny, Edwin Eidelberg, David Devinsky, Orrin Beric, Aleksandar |
| description | BACKGROUND Earlier approaches to pallidotomy for refractory Parkinson’s disease had significant complication rates. More recent approaches show fewer complications, but the effect of pallidotomy on cognition is unclear. The current study was conducted to examine the neuropsychological effects of unilateral pallidotomy. METHODS Neuropsychological testing was performed on patients with medically refractory, predominantly unilateral Parkinson’s disease at baseline and after unilateral ventral pallidotomy (n=28) or after an equivalent period without surgery in control patients (n=10). RESULTS Pallidotomy patients showed no significant changes from baseline to retesting relative to the control group for any measure. Across all of the tests administered, only five of the surgery patients showed a significant decline, and of these five none declined on more than one test. Depression did not relate to preoperative or postoperative cognition. The pallidotomy group showed a significant improvement in motor functioning and activities of daily living whereas the control group did not. These measures were not associated with the neuropsychological test scores at baseline or retest. CONCLUSIONS Stereotactic unilateral ventral pallidotomy does not seem to produce dramatic cognitive declines in most patients. |
| doi_str_mv | 10.1136/jnnp.65.2.150 |
| format | Article |
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More recent approaches show fewer complications, but the effect of pallidotomy on cognition is unclear. The current study was conducted to examine the neuropsychological effects of unilateral pallidotomy. METHODS Neuropsychological testing was performed on patients with medically refractory, predominantly unilateral Parkinson’s disease at baseline and after unilateral ventral pallidotomy (n=28) or after an equivalent period without surgery in control patients (n=10). RESULTS Pallidotomy patients showed no significant changes from baseline to retesting relative to the control group for any measure. Across all of the tests administered, only five of the surgery patients showed a significant decline, and of these five none declined on more than one test. Depression did not relate to preoperative or postoperative cognition. The pallidotomy group showed a significant improvement in motor functioning and activities of daily living whereas the control group did not. These measures were not associated with the neuropsychological test scores at baseline or retest. CONCLUSIONS Stereotactic unilateral ventral pallidotomy does not seem to produce dramatic cognitive declines in most patients.</description><identifier>ISSN: 0022-3050</identifier><identifier>EISSN: 1468-330X</identifier><identifier>DOI: 10.1136/jnnp.65.2.150</identifier><identifier>PMID: 9703163</identifier><identifier>CODEN: JNNPAU</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Activities of daily living ; Activities of Daily Living - classification ; Aged ; Biological and medical sciences ; Cognition Disorders - diagnosis ; Cognition Disorders - etiology ; Cognitive ability ; Combined Modality Therapy ; Dementia ; Female ; Follow-Up Studies ; Globus Pallidus - surgery ; Humans ; Levodopa - administration & dosage ; Male ; Medical sciences ; Metabolic disorders ; Middle Aged ; Morbidity ; Mortality ; Neuropsychological Tests ; Neurosurgery ; pallidotomy ; Parkinson Disease - surgery ; Parkinson's disease ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Skull, brain, vascular surgery ; Stereotaxic Techniques ; Studies ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Treatment Outcome</subject><ispartof>Journal of neurology, neurosurgery and psychiatry, 1998-08, Vol.65 (2), p.150-154</ispartof><rights>Journal of Neurology, Neurosurgery, and Psychiatry</rights><rights>1998 INIST-CNRS</rights><rights>Copyright: 1998 Journal of Neurology, Neurosurgery, and Psychiatry</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b510t-fc349e7270fe8a44e68b652d500a2b5aa02d1e22815885b4713595f81a22715d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2170208/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2170208/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2337876$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9703163$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Perrine, Kenneth</creatorcontrib><creatorcontrib>Dogali, Michael</creatorcontrib><creatorcontrib>Fazzini, Enrico</creatorcontrib><creatorcontrib>Sterio, Djorje</creatorcontrib><creatorcontrib>Kolodny, Edwin</creatorcontrib><creatorcontrib>Eidelberg, David</creatorcontrib><creatorcontrib>Devinsky, Orrin</creatorcontrib><creatorcontrib>Beric, Aleksandar</creatorcontrib><title>Cognitive functioning after pallidotomy for refractory Parkinson’s disease</title><title>Journal of neurology, neurosurgery and psychiatry</title><addtitle>J Neurol Neurosurg Psychiatry</addtitle><description>BACKGROUND Earlier approaches to pallidotomy for refractory Parkinson’s disease had significant complication rates. More recent approaches show fewer complications, but the effect of pallidotomy on cognition is unclear. The current study was conducted to examine the neuropsychological effects of unilateral pallidotomy. METHODS Neuropsychological testing was performed on patients with medically refractory, predominantly unilateral Parkinson’s disease at baseline and after unilateral ventral pallidotomy (n=28) or after an equivalent period without surgery in control patients (n=10). RESULTS Pallidotomy patients showed no significant changes from baseline to retesting relative to the control group for any measure. Across all of the tests administered, only five of the surgery patients showed a significant decline, and of these five none declined on more than one test. Depression did not relate to preoperative or postoperative cognition. The pallidotomy group showed a significant improvement in motor functioning and activities of daily living whereas the control group did not. These measures were not associated with the neuropsychological test scores at baseline or retest. CONCLUSIONS Stereotactic unilateral ventral pallidotomy does not seem to produce dramatic cognitive declines in most patients.</description><subject>Activities of daily living</subject><subject>Activities of Daily Living - classification</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - etiology</subject><subject>Cognitive ability</subject><subject>Combined Modality Therapy</subject><subject>Dementia</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Globus Pallidus - surgery</subject><subject>Humans</subject><subject>Levodopa - administration & dosage</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic disorders</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Neuropsychological Tests</subject><subject>Neurosurgery</subject><subject>pallidotomy</subject><subject>Parkinson Disease - surgery</subject><subject>Parkinson's disease</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - etiology</subject><subject>Skull, brain, vascular surgery</subject><subject>Stereotaxic Techniques</subject><subject>Studies</subject><subject>Surgery</subject><subject>Surgery (general aspects). 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More recent approaches show fewer complications, but the effect of pallidotomy on cognition is unclear. The current study was conducted to examine the neuropsychological effects of unilateral pallidotomy. METHODS Neuropsychological testing was performed on patients with medically refractory, predominantly unilateral Parkinson’s disease at baseline and after unilateral ventral pallidotomy (n=28) or after an equivalent period without surgery in control patients (n=10). RESULTS Pallidotomy patients showed no significant changes from baseline to retesting relative to the control group for any measure. Across all of the tests administered, only five of the surgery patients showed a significant decline, and of these five none declined on more than one test. Depression did not relate to preoperative or postoperative cognition. The pallidotomy group showed a significant improvement in motor functioning and activities of daily living whereas the control group did not. These measures were not associated with the neuropsychological test scores at baseline or retest. CONCLUSIONS Stereotactic unilateral ventral pallidotomy does not seem to produce dramatic cognitive declines in most patients.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>9703163</pmid><doi>10.1136/jnnp.65.2.150</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Activities of daily living Activities of Daily Living - classification Aged Biological and medical sciences Cognition Disorders - diagnosis Cognition Disorders - etiology Cognitive ability Combined Modality Therapy Dementia Female Follow-Up Studies Globus Pallidus - surgery Humans Levodopa - administration & dosage Male Medical sciences Metabolic disorders Middle Aged Morbidity Mortality Neuropsychological Tests Neurosurgery pallidotomy Parkinson Disease - surgery Parkinson's disease Postoperative Complications - diagnosis Postoperative Complications - etiology Skull, brain, vascular surgery Stereotaxic Techniques Studies Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Treatment Outcome |
| title | Cognitive functioning after pallidotomy for refractory Parkinson’s disease |
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