Objective: We hypothesized that face recognition and color perception may also be impaired after STN DBS and we tested our hypothesis in a group of PD patients who underwent this operation.

Background: Deep brain stimulation (DBS) of either subthalamic nucleus (STN) or globus pallidus interna (GPi) is now more widely used treatment method in PD with motor fluctuations or dyskinesia. However, they are both associated with mild cognitive decline. A meta-analysis demonstrated that the most significant decline after STN DBS was in verbal fluency. However, particular studies provided evidences for worsening of facial expression, apathy or attention after STN DBS.

Methods: We included consecutive idiopathic PD patients who underwent bilateral STN DBS according to standard previously published selection and exclusion criteria. All the patients who were assessed once within the last 3 months before surgery and in the first year after the surgery using motor, psychiatric and neuropsychological assessments were included in the study. A detailed neuropsychological battery was performed which included Digit Span, Stroop, Benton Face Recognition, Hooper Visual Organization Tests (HVOT) and figure copy. Mean on and off motor UPDRS scores, LDED, and scores of neuropsychiatric tests were compared between preoperative and postoperative conditions using Wilcoxon test. Deficits of color perception and figure copy test were compared using chi square test.

Results: There were 14 patients who met the study criteria. Mean age at the time of surgery was 49.9±5.8 years. There were 10 (71.4%) male patients. Preoperative and postoperative UPDRS motor scores during on and off periods reduced significantly (p=0.027). LDED was also significantly decreased (p=0.027). All patients completed the abovementioned neuropsychological tests except one who could only participate in digit span tests. There were no significant changes of neuropsychological tests between preoperative and postoperative conditions except for the Stroop color naming test which was impaired at the postoperative condition (15.0±3.8 vs 19.5±8.0 sec, p=0.027).

Conclusions: Stroop naming test may represent color recognition. Although the operation did not lead to global decline in cognition, color recognition may deteriorate after STN DBS. However, further studies with bigger patient populations are required.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/face-and-color-recognition-after-subthalamic-nucleus-stimulation-in-parkinsons-disease/