Session Information
Date: Wednesday, June 22, 2016
Session Title: Parkinson's disease: Cognition
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To assess cognitive and neuropsychiatric effects of unilateral subthalamotomy in Parkinson´s disease (PD) and their correlation with lesion size.
Background: Surgery for treatment of PD motor signs is effective, but its precise consequence in non-motor domains still remains controversial. Prior studies investigated lesion effects from bilateral subthalamotomy but yet no information on STN unilateral lesions is at hand.
Methods: Fourteen PD patients (5 right, 9 left subthalamotomy) were evaluated pre and post surgery while ON medication. The mean post-surgery evaluation was 6 months. In addition to motor assessments, cognitive evaluations (MMSE, FAB, DRS, verbal fluency, executive function, learning), quality of life and neuropsychiatric assessments (apathy, depression, anxiety, mania, hypo- and hyperdopaminergic states, impulsivity) and volume of lesions from MRI were obtained.
Results: After surgery, as expected significant motor improvement was observed. Subthalamotomy improved general cognitive status, but left lesions reduced verbal fluency compared to before surgery. Anxiety, depression and quality of life scores were significantly improved after surgery. However, specific hyper-emotionality was present after surgery. Moreover, right subthalamotomy led to disinhibition which was associated with larger volume lesions, as shown by correlations with post-surgery MRI.
Conclusions: Right and left subthalamotomy produced beneficial effects on quality of life, general cognitive status and mood in PD. However, right subthalamotomy increased disinhibition associated with larger lesions size and left subthalamotomy induced deficits in verbal fluency. Overall, unilateral subthalamotomy is an effective treatment for motor symptoms and non-motor signs of PD, but right subthalamotomy may carry greater risk of adverse neuropsychiatric effects.
Sociedad española de Neurología (SEN), Valencia, Spain. November 2015.
To cite this abstract in AMA style:
I. Obeso, E. Casabona, R. Rodríguez-Rojas, N. Pavón, R. Macías, M.L. Bringas, J.A. Obeso, M. Jahanshahi. Unilateral subthalamotomy in Parkinson´s disease: Cognitive and neuropsychiatric effects and correlation with lesion size [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/unilateral-subthalamotomy-in-parkinsons-disease-cognitive-and-neuropsychiatric-effects-and-correlation-with-lesion-size/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/unilateral-subthalamotomy-in-parkinsons-disease-cognitive-and-neuropsychiatric-effects-and-correlation-with-lesion-size/