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Cognitive functioning after pallidotomy for refractoryParkinson's disease |
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| Authors: | K. Perrine M. Dogali E. Fazzini D. Sterio E. Kolodny D. Eidelberg O. Devinsky A. Beric |
| Affiliation: | Department of Neurology, NYU School of Medicine and Hospital for Joint Diseases, New York 10003, USA. |
| Abstract: | BACKGROUND—Earlierapproaches to pallidotomy for refractory Parkinson's disease hadsignificant complication rates. More recent approaches show fewercomplications, but the effect of pallidotomy on cognition is unclear.The current study was conducted to examine the neuropsychological effects of unilateral pallidotomy. METHODS—Neuropsychologicaltesting was performed on patients with medically refractory,predominantly unilateral Parkinson's disease at baseline andafter unilateral ventral pallidotomy (n=28)or after an equivalent period withoutsurgery in control patients (n=10). RESULTS—Pallidotomypatients showed no significant changes from baseline to retestingrelative to the control group for any measure. Across all of the testsadministered, only five of the surgery patients showed a significantdecline, 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 motorfunctioning and activities of daily living whereas the control groupdid not. These measures were not associated with the neuropsychologicaltest scores at baseline or retest. CONCLUSIONS—Stereotacticunilateral ventral pallidotomy does not seem to produce dramaticcognitive declines in most patients. |
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