Pallidal stimulation in dystonia: effects on cognition, mood, and quality of life

• Published in: Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2005-12, Vol.76 (12), p.1713-1716
• Main Authors: Hälbig, T D, Gruber, D, Kopp, U A, Schneider, G-H, Trottenberg, T, Kupsch, A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Affect; Aged; BFMDRS; Biological and medical sciences; Burke–Fahn–Marsden Dystonia Rating Scale; Cognition; Cognition & reasoning; DBS; Deep brain stimulation; Deep Brain Stimulation - adverse effects; Deep Brain Stimulation - methods; Diseases of striated muscles. Neuromuscular diseases; Dystonia; Dystonia - therapy; Electrodes; Electrodes, Implanted; Executive function; Female; Functional Laterality; Globus Pallidus - physiology; globus pallidus internus; GPi; Humans; Male; Medical sciences; Middle Aged; mood; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Neuropsychology; Parkinson's disease; Patients; Quality of Life; Short Report; Surgery; TMT; Trail Making Test; Treatment Outcome
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2004.057992

Bilateral deep brain stimulation (DBS) of the globus pallidus internus (GPi) alleviates symptoms in patients with dystonia but its effects on cognition, neuropsychiatric status, and quality of life have not been examined. This is a case series report of 15 consecutive patients with different forms of dystonia who underwent bilateral implantation of DBS electrodes in the GPi. The patients were evaluated preoperatively and after 3–12 months of DBS with tests of cognition (Mattis Dementia Rating Scale, Stroop Test, Trail Making Test, Phonemic and Category Word Fluency, Digit Span, Rey Auditory Verbal Learning Test, Tonic and Phasic Alertness), neuropsychiatric status (Beck Depression and Anxiety Inventories, Montgomery Asberg Depression Rating Scale, Snaith–Hamilton Pleasure Scale, Brief Psychiatric Rating Scale), quality of life, and motor functions. GPi DBS significantly improved dystonic symptoms, functional abilities, and quality of life allowing for a significant reduction of antidystonic medications. No deterioration was observed in cognitive scores and neuropsychiatric measures. The present case series report thus provides preliminary evidence for the safety of GPi DBS regarding cognitive and neuropsychiatric functions in patients with dystonia.