Volume 24, Issue 11 p. 1621-1628
Research Article

Deep brain stimulation and cognitive functions in Parkinson's disease: A three-year controlled study

Roberta Zangaglia MD

Roberta Zangaglia MD

Parkinson's Disease and Movement Disorders Unit, IRCCS “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

Interdepartmental Research Center for Parkinson's Disease, “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

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Claudio Pacchetti MD

Claudio Pacchetti MD

Parkinson's Disease and Movement Disorders Unit, IRCCS “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

Interdepartmental Research Center for Parkinson's Disease, “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

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Chiara Pasotti MD

Chiara Pasotti MD

Interdepartmental Research Center for Parkinson's Disease, “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

Laboratory of Neuropsychology, “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

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Francesca Mancini MD

Francesca Mancini MD

Unit of Neurology, San Pio X Institute, Milan, Italy

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Domenico Servello MD

Domenico Servello MD

Unit of Functional Neurosurgery, IRCCS Galeazzi Insitute, Milan, Italy

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Elena Sinforiani MD

Corresponding Author

Elena Sinforiani MD

Interdepartmental Research Center for Parkinson's Disease, “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

Laboratory of Neuropsychology, “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

Laboratory of Neuropsychology, IRCCS C. Mondino, via Mondino 2, 27100 Pavia, ItalySearch for more papers by this author
Silvano Cristina MD

Silvano Cristina MD

Parkinson's Disease and Movement Disorders Unit, IRCCS “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

Interdepartmental Research Center for Parkinson's Disease, “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

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Marco Sassi MD

Marco Sassi MD

Unit of Functional Neurosurgery, IRCCS Galeazzi Insitute, Milan, Italy

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Giuseppe Nappi MD

Giuseppe Nappi MD

Interdepartmental Research Center for Parkinson's Disease, “C. Mondino Institute of Neurology” Foundation, Pavia, Italy

Chair of Neurology, University “La Sapienza”, Rome, Italy

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First published: 09 June 2009
Citations: 90

Potential conflict of interest: None reported.

Abstract

There is debate over the cognitive and behavioral effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in advanced Parkinson's disease (PD). To evaluate these effects, we performed a prospective, naturalistic controlled, 3-year follow-up study. A total of 65 PD patients were enrolled, of whom 32 underwent STN-DBS (PD-DBS) and 33, even though eligible for this treatment, declined surgery and chose other therapeutic procedures (PD-control). Motor and neuropsychological functions were assessed in all the subjects at baseline (T0) and 36 months (T36). The PD-DBS patients were also evaluated at 1, 6, 12, and 24 months after surgery (T1, T6, T12, and T24). At T1, compared with T0, the PD-DBS patients recorded worse logical executive function task and verbal fluency (FAS) scores, whereas their performance of memory tasks remained stable. At T12, their cognitive profile had returned within the pre-DBS range, thereafter remaining stable until T36. FAS scores at T36 were significantly worse in the PD-DBS compared with the PD-control patients. This is the first long-term naturalistic controlled study of cognitive functions in PD patients submitted to STN-DBS. Our results confirm previous reports of a worsening of verbal fluency after DBS, but show that STN-DBS seems to be relatively safe from a cognitive standpoint, as the short-term worsening of frontal-executive functions was found to be transient. © 2009 Movement Disorder Society