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From the Departments of Neurology (H.M.M.S., J.D.S., B.S.) and Neurosurgery (P.R.S.), Academic Medical Center/University of Amsterdam; Department of Neurology (M.K.-H., T.v.L.), University Medical Center Groningen; and Department of Neurology (P.N.), Sint Elisabeth Hospital Tilburg, the Netherlands.
Address correspondence and reprint requests to H.M.M. Smeding, Department of Neurology, H2-222, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, the Netherlands; e-mail: h.m.smeding{at}amc.uva.nl
Objective: To evaluate the cognitive and behavioral effects of bilateral subthalamic nucleus (STN) stimulation in patients with Parkinson disease (PD).
Methods: The authors included 103 patients; 99 patients were evaluated 6 months after surgery. A control group of 39 patients with PD was formed and 36 patients were evaluated 6 months later. At baseline and at follow-up we administered neuropsychological tests of language, memory, visuospatial function, mental speed, and executive functions. A depression rating scale, a quality of life scale, self and proxy ratings of memory and dysexecutive symptoms, and a neuropsychiatric interview were also administered.
Results: Six months after surgery, the STN group showed a larger decline than the control group on measures of verbal fluency, color naming, selective attention, and verbal memory. Moreover, the STN group showed a decrease in positive affect, and an increase in emotional lability and cognitive complaints. On the other hand, the STN group showed an increase in quality of life and a slight decrease in depressive symptoms. Nine percent of the STN patients had psychiatric complications (vs 3% of controls).
Conclusions: Bilateral subthalamic nucleus stimulation has an adverse effect on executive functions with implications for daily life of the patients and their relatives.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the June 27 issue to find the title link for this article.
Editorial, see page 1799
See also page 1811
Supported by a grant from the Prinses Beatrix Fonds and the Parkinson patiëntenvereniging.
Disclosure: J.D. Speelman acts as an independent consultant for Medtronic Ltd. (Minneapolis). He has received travel grants from Medtronic Ltd. For the other authors no financial interests or other potential conflicts are involved.
Received November 14, 2005. Accepted in final form April 17, 2006.
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