Volume 26, Issue S1 p. S63-S78
Supplement

Neuropsychological, neuropsychiatric, and quality of life issues in DBS for dystonia

Marjan Jahanshahi PhD

Corresponding Author

Marjan Jahanshahi PhD

UCL Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom

Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, University College London, Queen's Square, London. WC1N 3BG, United KingdomSearch for more papers by this author
Virginie Czernecki PhD

Virginie Czernecki PhD

Inserm CRICM U975, Department of Neurology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France

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and Mateusz Zurowski MD

and Mateusz Zurowski MD

Department of Psychiatry, Toronto Western Hospital, University of Toronto, Toronto, Canada

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First published: 20 June 2011
Citations: 52

Potential conflicts of interest: Nothing to report.

Abstract

We review the impact of dystonia and its surgical treatment with deep brain stimulation (DBS) on cognitive function, psychiatric morbidity, and health-related quality of life. The current evidence suggests that globus pallidus internus (GPi) DBS does not cause cognitive decline in primary dystonia. However, we recommend general preoperative screening of cognition in patients with dystonia to evaluate baseline cognitive status and monitor for possible postoperative changes. Patients with mild to moderate depression appear to do well postoperatively; however, there are scant data about those with severe depression. This is particularly problematic given reports of postoperative suicide. Patients with tardive dystonia seem to do well post-GPi DBS despite often having a history of depression or even having active severe depression. We make recommendations for screening and basic management strategies of patients identified as having a major psychiatric illness pre- or postoperatively. Quality of life in dystonia patients quantified by generic measures such as the SF36 showed improvement in both mental and physical categories following DBS surgery. © 2011 Movement Disorder Society