David J Pedrosa1, Michelle Auth2, K Amande M Pauls2, Matthias Runge3, Mohammad Maarouf3, Gereon R Fink4, Lars Timmermann2. 1. Department of Neurology, University Hospital Cologne, Cologne, Germany. Electronic address: david.pedrosa@uk-koeln.de. 2. Department of Neurology, University Hospital Cologne, Cologne, Germany. 3. Department of Stereotaxy and Functional Neurosurgery, University Hospital Cologne, Cologne, Germany. 4. Department of Neurology, University Hospital Cologne, Cologne, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Germany.
Abstract
OBJECTIVE: To assess the effects of different frequencies of thalamic Deep-Brain-Stimulation (DBS) on cognitive performance of patients suffering from Essential Tremor (ET). METHODS: In 17 ET-patients with thalamic-DBS, Tremor-Rating-Scale (TRS), standardized phonemic and semantic verbal fluency (VF), Stroop-Color-Word-Test and Digit-span-test were investigated in three randomized stimulation-settings: i) high-frequency stimulation (HFS), ii) low-frequency stimulation (LFS) and iii) OFF-stimulation (DBS-OFF). Paired-samples t-test for TRS and one-way repeated measures analysis of variance for cognitive performance were calculated. RESULTS:Tremor was reduced during HFS (MeanTRS-HFS = 12.9 ± 9.6) compared to DBS-OFF (MeanTRS-OFF = 44.4 ± 19.8, P < .001) and to LFS (MeanTRS-10 Hz = 50.0 ± 24.2; P < .001). While performance of Stroop-task and digit-span remained unaffected by stimulation-settings (P > .05), phonemic and semantic VF differed significantly between the three conditions (FPvf = 5.28, FSvf = 3.41, both P < .05). Post-hoc comparisons revealed significant differences for both phonemic and semantic VF between LFS (MeanPvf-10 Hz = 54.6 ± 9.2, MeanSvf-10 Hz = 56.4 ± 7.9) and HFS (MeanPvf-ON = 48.3 ± 11.4, MeanSvf-ON = 51.1 ± 11.0, both P < .05), while DBS-OFF (MeanPvf-OFF = 51.2 ± 9.3, MeanSvf-OFF = 53.6 ± 12.9) and HFS and DBS-OFF and LFS did not differ significantly (P > .05). CONCLUSIONS: HFS compared to LFS or DBS-OFF significantly reduced tremor but simultaneously worsened VF while working memory and cognitive inhibition remained unaffected. In contrast, LFS enhanced VF but did not ameliorate tremor. The data emphasize the relevance of thalamocortical loops for verbal fluency but also suggest that more sophisticated DBS-regimes in ET may improve both motor and cognitive performance.
RCT Entities:
OBJECTIVE: To assess the effects of different frequencies of thalamic Deep-Brain-Stimulation (DBS) on cognitive performance of patients suffering from Essential Tremor (ET). METHODS: In 17 ET-patients with thalamic-DBS, Tremor-Rating-Scale (TRS), standardized phonemic and semantic verbal fluency (VF), Stroop-Color-Word-Test and Digit-span-test were investigated in three randomized stimulation-settings: i) high-frequency stimulation (HFS), ii) low-frequency stimulation (LFS) and iii) OFF-stimulation (DBS-OFF). Paired-samples t-test for TRS and one-way repeated measures analysis of variance for cognitive performance were calculated. RESULTS:Tremor was reduced during HFS (MeanTRS-HFS = 12.9 ± 9.6) compared to DBS-OFF (MeanTRS-OFF = 44.4 ± 19.8, P < .001) and to LFS (MeanTRS-10 Hz = 50.0 ± 24.2; P < .001). While performance of Stroop-task and digit-span remained unaffected by stimulation-settings (P > .05), phonemic and semantic VF differed significantly between the three conditions (FPvf = 5.28, FSvf = 3.41, both P < .05). Post-hoc comparisons revealed significant differences for both phonemic and semantic VF between LFS (MeanPvf-10 Hz = 54.6 ± 9.2, MeanSvf-10 Hz = 56.4 ± 7.9) and HFS (MeanPvf-ON = 48.3 ± 11.4, MeanSvf-ON = 51.1 ± 11.0, both P < .05), while DBS-OFF (MeanPvf-OFF = 51.2 ± 9.3, MeanSvf-OFF = 53.6 ± 12.9) and HFS and DBS-OFF and LFS did not differ significantly (P > .05). CONCLUSIONS: HFS compared to LFS or DBS-OFF significantly reduced tremor but simultaneously worsened VF while working memory and cognitive inhibition remained unaffected. In contrast, LFS enhanced VF but did not ameliorate tremor. The data emphasize the relevance of thalamocortical loops for verbal fluency but also suggest that more sophisticated DBS-regimes in ET may improve both motor and cognitive performance.
Authors: William S Gibson; Hang Joon Jo; Paola Testini; Shinho Cho; Joel P Felmlee; Kirk M Welker; Bryan T Klassen; Hoon-Ki Min; Kendall H Lee Journal: Brain Date: 2016-06-21 Impact factor: 13.501
Authors: Hayriye Cagnan; David Pedrosa; Simon Little; Alek Pogosyan; Binith Cheeran; Tipu Aziz; Alexander Green; James Fitzgerald; Thomas Foltynie; Patricia Limousin; Ludvic Zrinzo; Marwan Hariz; Karl J Friston; Timothy Denison; Peter Brown Journal: Brain Date: 2016-12-22 Impact factor: 13.501
Authors: Jacob D Jones; Tatiana Orozco; Dawn Bowers; Wei Hu; Zakia Jabarkheel; Shannon Chiu; Adolfo Ramirez-Zamora; Kelly Foote; Michael S Okun; Aparna Wagle Shukla Journal: Front Hum Neurosci Date: 2020-12-11 Impact factor: 3.169
Authors: Robert Francis Dallapiazza; Darrin J Lee; Philippe De Vloo; Anton Fomenko; Clement Hamani; Mojgan Hodaie; Suneil K Kalia; Alfonso Fasano; Andres M Lozano Journal: J Neurol Neurosurg Psychiatry Date: 2018-10-18 Impact factor: 10.154