Kognitive und emotionale Effekte der Tiefenhirnstimulation des Nucleus subthalamicus im Langzeitverlauf bei Patienten mit Morbus Parkinson : eine prospektive Studie
Kognitive und emotionale Effekte der Tiefenhirnstimulation des Nucleus subthalamicus im Langzeitverlauf bei Patienten mit Morbus Parkinson : eine prospektive Studie
A plain-language reading has not been prepared for this paper yet.
Original abstract
This prospective study evaluated the cognitive and emotional effects after deep brain stimulation of subthalamic nucleus in patients with Parkinson´s disease. The patients underwent neuropsychological examinations to assess the cognitive and emotional functioning before and after implantation. Postoperative assessments were carried out with stimulators both turned on and turned off. The examinations took place between 2004 and 2006 in the Department of Neurology and Psychiatry and Psychotherapy of the Heinrich-Heine-University in Düsseldorf in close collaboration with the Department of Psychiatry and Psychotherapy in Aachen. The patients had been operated in the Clinic for Stereotaxy and functional Neurosurgery in Cologne. There exist many investigations to assess the motor symptoms as well as the cognitive and emotional effects after deep brain stimulation. Nevertheless its effects on the mental in comparison to the physical aspects remain controversial/unknown. Very few studies evaluated the effect of the operation on the neuropsychological functioning (Surgery effect). In our investigations postoperative deterioration in verbal fluency was observed. 3-4 months after the surgery, the performance showed a significant improvement. In accordance to the other studies there still remains a negative long-term effect on the verbal fluency after the treatment. A decline of cognitive flexibility was also observed after the implantation. The surgery effect decreases at the follow ups and the performance ameliorated. Hence, the deep brain stimulation seems to have a positive long-term effect on the cognitive flexibility. Neither the emotional and behavioural functions nor the cognition have been affected by the stimulation of the subthalamic nucleus (Stimulation comparison). Deep brain stimulation of the subthalamic nucleus is an established neurosurgical procedure for treatment of motor symptoms in patients with advanced Parkinson’s disease. Beyond the beneficial effects on motor symptoms there exist psychosocial aspects as attention, intellectual and emotional behaviour and the daily living activities that affect the quality of life. Corresponding to the most other studies our investigations showed a worsening in verbal fluency as the only neuropsychological change following deep brain stimulation of the subthalamic nucleus. It did not lead to other emotional or cognitive deterioration. In conclusion, long term subthalamic nucleus deep brain stimulation seems to be associated with low cognitive and emotional morbidity and can therefore be considered as a relative safe treatment/procedure for patients with advanced Parkinson’s disease.