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From Academic Medical Center (Drs. Schmand, de Bie, and Speelman), Department of Neurology, University of Amsterdam; University Hospital (M. Koning-Haanstra and Dr. van Zomeren), Department of Neurology, Groningen; and Twee Steden Hospital (J. de Smet), Department of Medical Psychology, Tilburg, the Netherlands.
Address correspondence and reprint requests to Dr. B. Schmand, Department of Neurology, H2-222, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, the Netherlands; e-mail: b.schmand{at}amc.uva.nl
OBJECTIVE: To investigate whether unilateral pallidotomy affects cognitive and behavioral functioning.
METHODS: At baseline and after 6 months we assessed neuropsychological functioning in 35 patients with advanced PD. After baseline examination, patients were randomized to pallidotomy within 1 month (6 left-sided, 13 right-sided) or to pallidotomy after follow-up assessment 6 months later (n = 16; control group). We performed neuropsychological tests of language, visuospatial function, memory, attention, and executive functions. Self ratings and proxy ratings of memory problems and dysexecutive symptoms were also collected.
RESULTS: No significant differences over time were found between pallidotomy and control groups, with the exception of a decrease of verbal fluency in the left-sided pallidotomy group.
CONCLUSIONS: Unilateral pallidotomy is relatively safe with respect to cognition and behavior. Left-sided pallidotomy may lead to minor deterioration in verbal fluency. The sample size of this study is too small, however, to rule out the possibility of infrequent but clinically important side effects.
Key words: PD—Stereotactic surgery—pallidotomy—Cognition disorders—Neuropsychological tests.
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