Differential Cognitive Effects of Unilateral Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease

• Published in: Annals of neurology 2024-06, Vol.95 (6), p.1205-1219
• Main Authors: Del Bene, Victor A, Martin, Roy C., Brinkerhoff, Sarah A., Olson, Joseph W., Nelson, Matthew J., Marotta, Dario, Gonzalez, Christopher L., Mills, Kelly A., Kamath, Vidyulata, Cutter, Gary, Hurt, Chris P., Wade, Melissa, Robinson, Frank G., Bentley, J. Nicole, Guthrie, Barton L., Knight, Robert T., Walker, Harrison C.
• Format: Article
• Language: English
• Subjects: Aged; Basal ganglia; Brain; Central nervous system diseases; Cognition; Cognition & reasoning; Cognition - physiology; Cognitive ability; Cognitive tasks; Cross-Over Studies; Deep brain stimulation; Deep Brain Stimulation - adverse effects; Deep Brain Stimulation - methods; Double-Blind Method; Electrical stimuli; Female; Humans; Implants; Inhibition (psychology); Male; Middle Aged; Movement disorders; Neurodegenerative diseases; Parkinson Disease - physiopathology; Parkinson Disease - therapy; Parkinson's disease; Recall; Solitary tract nucleus; Stimulation; Subthalamic Nucleus; Transplants & implants
• ISSN: 0364-5134; 1531-8249; 1531-8249
• DOI: 10.1002/ana.26903

Objective The aim of this study was to investigate the cognitive effects of unilateral directional versus ring subthalamic nucleus deep brain stimulation (STN DBS) in patients with advanced Parkinson's disease. Methods We examined 31 participants who underwent unilateral STN DBS (left n = 17; right n = 14) as part of an National Institutes of Health (NIH)‐sponsored randomized, double‐blind, crossover study contrasting directional versus ring stimulation. All participants received unilateral DBS implants in the hemisphere more severely affected by motor parkinsonism. Measures of cognition included verbal fluency, auditory‐verbal memory, and response inhibition. We used mixed linear models to contrast the effects of directional versus ring stimulation and implant hemisphere on longitudinal cognitive function. Results Crossover analyses showed no evidence for group‐level changes in cognitive performance related to directional versus ring stimulation. Implant hemisphere, however, impacted cognition in several ways. Left STN participants had lower baseline verbal fluency than patients with right implants (t [20.66 = −2.50, p = 0.02]). Verbal fluency declined after left (p = 0.013) but increased after right STN DBS (p