Abstract
Although many studies have shown no significant change in global cognitive function after subthalamic brain stimulation (STN DBS) in patients with Parkinson disease (PD) and have concluded that STN DBS is generally safe from a cognitive standpoint, some studies have reported a decline in global cognitive function after STN DBS. Interestingly, in some studies, the decline in cognitive function appears to be greater during the initial short period after surgery (within 6 or 12 months after surgery) than the decline thereafter. To this end, we examined whether the rate of change in global cognitive function during the initial 6 months after STN DBS was different from the mean 6-month change that occurred between 6 and 36 months after surgery. Thirty-six PD patients who underwent bilateral STN DBS and were followed for more than 3 years were included. Change in Mini-Mental Status Examination (MMSE) score during the first 6 months after surgery was compared with the 6-month MMSE score change between 6 and 36 months after surgery. Mean MMSE change during the first 6 months after surgery was significantly greater than the mean 6-month MMSE change between 6 to 36 months after surgery. The levodopa equivalent daily dose at baseline and the score for Stroop Color-word test at baseline were significantly associated with the decline in MMSE score during the first 6 months after surgery. Our result showed that decline in global cognitive function was faster in the first 6 months after surgery, compared with that after 6 months.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Massano J, Garrett C (2012) Deep brain stimulation and cognitive decline in Parkinson’s disease: a clinical review. Front Neurol 3:66. doi:10.3389/fneur.2012.00066
Witt K, Daniels C, Reiff J, Krack P, Volkmann J, Pinsker MO, Krause M, Tronnier V, Kloss M, Schnitzler A (2008) Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s disease: a randomised, multicentre study. Lancet Neurol 7:605–614
Fasano A, Romito LM, Daniele A, Piano C, Zinno M, Bentivoglio AR, Albanese A (2010) Motor and cognitive outcome in patients with Parkinson’s disease 8 years after subthalamic implants. Brain 133:2664–2676
Merola A, Zibetti M, Angrisano S, Rizzi L, Ricchi V, Artusi CA, Lanotte M, Rizzone MG, Lopiano L (2011) Parkinson’s disease progression at 30 years: a study of subthalamic deep brain-stimulated patients. Brain 134:2074–2084
Schüpbach W, Chastan N, Welter M, Houeto J, Mesnage V, Bonnet A, Czernecki V, Maltete D, Hartmann A, Mallet L (2005) Stimulation of the subthalamic nucleus in Parkinson’s disease: a 5 year follow up. J Neurol Neurosurg Psychiatry 76:1640–1644
Smeding HMM, Speelman JD, Huizenga HM, Schuurman PR, Schmand B (2011) Predictors of cognitive and psychosocial outcome after STN DBS in Parkinson’s disease. J Neurol Neurosurg Psychiatry 82:754–760
Aybek S, Gronchi-Perrin A, Berney A, Chiuvé SC, Villemure JG, Burkhard PR, Vingerhoets FJG (2007) Long-term cognitive profile and incidence of dementia after STN-DBS in Parkinson’s disease. Mov Disord 22:974–981
Funkiewiez A, Ardouin C, Caputo E, Krack P, Fraix V, Klinger H, Chabardes S, Foote K, Benabid A, Pollak P (2004) Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease. J Neurol Neurosurg Psychiatry 75:834–839
Heo JH, Lee KM, Paek SH, Kim MJ, Lee JY, Kim JY, Cho SY, Lim YH, Kim MR, Jeong SY (2008) The effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) on cognition in Parkinson disease. J Neurol Sci 273:19–24
Yamanaka T, Ishii F, Umemura A, Miyata M, Horiba M, Oka Y, Yamada K, Okita K, Matsukawa N, Ojika K (2011) Temporary deterioration of executive function after subthalamic deep brain stimulation in Parkinson’s disease. Clin Neurol Neurosurg 14:347–351
Zangaglia R, Pacchetti C, Pasotti C, Mancini F, Servello D, Sinforiani E, Cristina S, Sassi M, Nappi G (2009) Deep brain stimulation and cognitive functions in Parkinson’s disease: a three-year controlled study. Mov Disord 24:1621–1628
Kim HJ, Jeon BS, Paek SH, Lee JY, Kim HJ, Kim CK, Kim DG (2010) Bilateral subthalamic deep brain stimulation in parkinson disease patients with severe tremor. Neurosurgery 67:626–632
Cools R, Stefanova E, Barker RA, Robbins TW, Owen AM (2002) Dopaminergic modulation of high-level cognition in Parkinson’s disease: the role of the prefrontal cortex revealed by PET. Brain 125:584–594
Daniels C, Krack P, Volkmann J, Pinsker MO, Krause M, Tronnier V, Kloss M, Schnitzler A, Wojtecki L, Bötzel K (2010) Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson’s disease. Mov Disord 25:1583–1589
Acknowledgments
This study was supported by a grant of the Korea Health technology R&D Project, Ministry of Health and Welfare, Republic of Korea. (A101273, BSJ).
Conflicts of interest
Dr. BS. Jeon has received funding for travel from Medtronics. The rest of the authors do not have conflicts of interest to disclose.
Author information
Authors and Affiliations
Corresponding authors
Rights and permissions
About this article
Cite this article
Kim, HJ., Jeon, B.S., Yun, J.Y. et al. Initial cognitive dip after subthalamic deep brain stimulation in Parkinson disease. J Neurol 260, 2130–2133 (2013). https://doi.org/10.1007/s00415-013-6959-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00415-013-6959-2