BACKGROUND: Neurocognitive outcome research of individuals with Parkinson's disease after unilateral pallidotomy is inconsistent. Although some studies reported few cognitive changes, other investigations have more consistently shown both transient and long-term cognitive decline postoperatively. METHODS: We report the long-term motor and neurocognitive outcome 5 years post surgery for 18 patients with Parkinson's disease (12 men and 6 woman; all right-handed) who underwent right or left unilateral posteroventral pallidotomy. RESULTS: Pallidotomy patients revealed long-term motor benefits from the surgery in their "off" state and control of dopa-induced dyskinesias in their "on" state, which is consistent with previous research. We found mild declines in oral and visuomotor information processing speed, verbal recognition memory, and mental status 5 years after surgery, which differs from previous literature regarding the long-term neurocognitive outcome after pallidotomy. Differences between the right and left pallidotomy patients for both motor and cognitive skills were not found. CONCLUSION: Although deep brain stimulation is presently the treatment of choice, pallidotomy continues to be performed around the world. Consequently, although unilateral pallidotomy should be considered a treatment option for patients with Parkinson's disease who suffer from severe unilateral disabling motor symptoms or dyskinesias, the long-term neurocognitive outcome should also be considered in treatment decisions.
BACKGROUND: Neurocognitive outcome research of individuals with Parkinson's disease after unilateral pallidotomy is inconsistent. Although some studies reported few cognitive changes, other investigations have more consistently shown both transient and long-term cognitive decline postoperatively. METHODS: We report the long-term motor and neurocognitive outcome 5 years post surgery for 18 patients with Parkinson's disease (12 men and 6 woman; all right-handed) who underwent right or left unilateral posteroventral pallidotomy. RESULTS: Pallidotomy patients revealed long-term motor benefits from the surgery in their "off" state and control of dopa-induced dyskinesias in their "on" state, which is consistent with previous research. We found mild declines in oral and visuomotor information processing speed, verbal recognition memory, and mental status 5 years after surgery, which differs from previous literature regarding the long-term neurocognitive outcome after pallidotomy. Differences between the right and left pallidotomy patients for both motor and cognitive skills were not found. CONCLUSION: Although deep brain stimulation is presently the treatment of choice, pallidotomy continues to be performed around the world. Consequently, although unilateral pallidotomy should be considered a treatment option for patients with Parkinson's disease who suffer from severe unilateral disabling motor symptoms or dyskinesias, the long-term neurocognitive outcome should also be considered in treatment decisions.
Authors: R Scott; R Gregory; N Hines; C Carroll; N Hyman; V Papanasstasiou; C Leather; J Rowe; P Silburn; T Aziz Journal: Brain Date: 1998-04 Impact factor: 13.501
Authors: A O Ceballos-Baumann; J A Obeso; J L Vitek; M R Delong; R Bakay; G Linazasoro; D J Brooks Journal: Lancet Date: 1994-09-17 Impact factor: 79.321
Authors: A E Lang; J Duff; J A Saint-Cyr; L Trepanier; R E Gross; W Lombardi; E Montgomery; W Hutchinson; A M Lozano Journal: J Neurol Date: 1999-09 Impact factor: 4.849
Authors: P K Pal; A Samii; A Kishore; M Schulzer; E Mak; S Yardley; I M Turnbull; D B Calne Journal: J Neurol Neurosurg Psychiatry Date: 2000-09 Impact factor: 10.154
Authors: Jason A R Carr; Christopher R Honey; Marci Sinden; Anthony G Phillips; Jeffrey S Martzke Journal: J Neurosurg Date: 2003-07 Impact factor: 5.115