Johanna Philipson1, Patric Blomstedt1, Marwan Hariz1,2, Marjan Jahanshahi2,3. 1. 1Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden. 2. 2Unit of Functional Neurosurgery, UCL Institute of Neurology, London, United Kingdom; and. 3. 3The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
Abstract
OBJECTIVE: The ventral intermediate nucleus (VIM) of the thalamus is currently the established target in the use of deep brain stimulation (DBS) to treat essential tremor (ET). In recent years, the caudal zona incerta (cZi), a brain target commonly used during the lesional era, has been revived as the primary target in a number of DBS studies that show evidence of the efficacy of cZi targeting in DBS treatment for controlling the symptoms of ET. The authors sought to obtain comprehensive neuropsychological data and thoroughly investigate the cognitive effects of cZi targeting in patients with ET treated with DBS. METHODS: Twenty-six consecutive patients with ET who received DBS with cZi as the target at our department from December 2012 to February 2017 were included in this study. All patients were assessed using a comprehensive neuropsychological test battery covering the major cognitive domains both preoperatively and 12 months postoperatively. RESULTS: The results show no major adverse effects on patient performance on the tests of cognitive function other than a slight decline of semantic verbal fluency. CONCLUSIONS: This study indicates that the cZi is a safe target from a cognitive perspective in the treatment of ET with DBS.
OBJECTIVE: The ventral intermediate nucleus (VIM) of the thalamus is currently the established target in the use of deep brain stimulation (DBS) to treat essential tremor (ET). In recent years, the caudal zona incerta (cZi), a brain target commonly used during the lesional era, has been revived as the primary target in a number of DBS studies that show evidence of the efficacy of cZi targeting in DBS treatment for controlling the symptoms of ET. The authors sought to obtain comprehensive neuropsychological data and thoroughly investigate the cognitive effects of cZi targeting in patients with ET treated with DBS. METHODS: Twenty-six consecutive patients with ET who received DBS with cZi as the target at our department from December 2012 to February 2017 were included in this study. All patients were assessed using a comprehensive neuropsychological test battery covering the major cognitive domains both preoperatively and 12 months postoperatively. RESULTS: The results show no major adverse effects on patient performance on the tests of cognitive function other than a slight decline of semantic verbal fluency. CONCLUSIONS: This study indicates that the cZi is a safe target from a cognitive perspective in the treatment of ET with DBS.
Entities:
Keywords:
BVMT-R = Brief Visuospatial Memory Test–Revised; CWIT = Color Word Interference Test; DBS = deep brain stimulation; ET = essential tremor; ETRS = Essential Tremor Rating Scale; MCI = mild cognitive impairment; NART-SWE = Swedish version of the National Adult Reading Test; PASAT = Paced Auditory Serial Addition Test; STN = subthalamic nucleus; TMT = Trail Making Test; VIM = ventral intermediate nucleus; VL = ventrolateral nucleus; WAIS-IV = Wechsler Adult Intelligence Scale–IV; cZi = caudal zona incerta; cognition; deep brain stimulation; essential tremor; functional neurosurgery; zona incerta
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