Objective: This case report illustrates the neuropsychological assessment of a Vietnamese-speaking man with PD as part of a comprehensive DBS evaluation.

Background: Neuropsychological evaluation is used to assess cognition in individuals considering deep brain stimulation (DBS) surgery and identify contraindications from cognitive or psychological perspectives, which include: dementia, cognitive functions suggestive of an additional disease process, or significant psychiatric disturbance. In Vietnamese-speaking individuals, the neuropsychological assessment is impacted by various factors, as there is a lack of Vietnamese tests, normative data, and culturally/linguistically-matched neuropsychologists.

Methods: We selected a battery of tests that covered all cognitive domains and adapted it for Vietnamese speakers, while taking into account patient QD’s level of endurance. Although the measures were translated into Vietnamese and QD was assessed by a neuropsychology postdoctoral fellow fluent in Vietnamese, there still remain language and cultural obstacles inherent within the tests. In addition, there are no test norms specifically for Vietnamese-speaking individuals; as such, test scores were interpreted with caution. Patient QD is a 76 year-old, Vietnamese-American man who was diagnosed with PD in 2010. Reported symptoms include tremor, rigidity, bradykinesia, and motor fluctuations. His medication regimen includes Stalevo, Sinemet, and Azilect. QD and his wife denied any significant problems with routine activities such as paying bills, or managing his schedule and appointments. QD completed 12 years of school in Vietnam.

Results: Overall performance on the neuropsychological evaluation revealed fluid intelligence in the average range, as measured by perceptual reasoning. Performance was intact across nearly all areas of cognition, including auditory attention and working memory, language, visual-perceptual and visuoconstructional skills, and executive functioning. On learning and memory measures, QD demonstrated stronger performance for visual relative to verbal information (see appendix). Emotionally, QD denied symptoms of depression or anxiety.

Conclusions: Qualitative observations, as well as language and cultural considerations, provide context for QD’s performance on neuropsychological testing. Given his overall pattern of performance, there were no contraindications for DBS surgery. A follow-up visit one month post-DBS surgery revealed that QD was recovering well.

References: 1. Ammic, M. M. & Grace, J. (2006). Deep brain stimulation surgery for Parkinson’s disease: The role of neuropsychological assessment. Med Health R I, 89(4), 409-414. 2. Fujii, D. (2011). The Neuropsychology of Asian Americans. New York, NY: Taylor & Francis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuropsychological-evaluation-of-a-vietnamese-speaking-man-with-parkinsons-disease-and-consideration-for-deep-brain-stimulation-surgery-a-case-report/