Obeso, I;
Casabona, E;
Rodriguez-Rojas, R;
Luisa Bringas, M;
Macias, R;
Pavon, N;
Obeso, JA;
(2017)
Unilateral subthalamotomy in Parkinson's disease: Cognitive, psychiatric and, neuroimaging changes.
Cortex
, 94
pp. 39-48.
10.1016/j.cortex.2017.06.006.
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Abstract
Unilateral subthalamotomy is an effective treatment for the cardinal motor features of Parkinson's disease (PD). However, non-motor changes possibly associated with right or left subthalamotomy remain unknown. Our aim was to assess cognitive, psychiatric and neuroimaging changes after treatment with unilateral subthalamotomy. Fourteen medicated patients with PD were evaluated before and after (mean 6 months after operation) unilateral subthalamotomy (5 right, 9 left). In addition to motor assessments, cognitive (global cognition and executive functions), psychiatric (apathy, depression, anxiety, mania, hypo- and hyperdopaminergic behaviours, impulsivity), quality of life evaluations and volume of lesions were obtained. After surgery, significant improvement of motor signs was observed. Unilateral subthalamotomy improved general cognitive status, but left subthalamotomy reduced semantic verbal fluency compared to the pre-operative state. Depression and quality of life were improved with both right and left subthalamotomy. However, hyper-emotionality was present after surgery and right subthalamotomy increased impulsivity and disinhibition (on NeuroPsychiatric Inventory and Ardouin Scale for Behaviour in PD), a result linked to larger lesion volumes. We conclude that unilateral subthalamotomy is effective for treating the cardinal motor features of PD and improves mood. Right subthalamotomy is associated with greater risk of impulsivity and disinhibition, while left subthalamotomy induces further impairment of semantic verbal fluency.
| Type: | Article |
|---|---|
| Title: | Unilateral subthalamotomy in Parkinson's disease: Cognitive, psychiatric and, neuroimaging changes |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.cortex.2017.06.006 |
| Publisher version: | http://doi.org/10.1016/j.cortex.2017.06.006 |
| Language: | English |
| Additional information: | © 2017 Elsevier Ltd. All rights reserved. This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Behavioral Sciences, Neurosciences, Neurosciences & Neurology, Subthalamic nucleus, Subthalamotomy, Disinhibition, Basal ganglia, Impulsivity, DEEP BRAIN-STIMULATION, VERBAL FLUENCY, BILATERAL STIMULATION, NUCLEUS, DEPRESSION, SPEECH, SCALE, CONNECTIVITY, INHIBITION, INVENTORY |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1567530 |
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