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Clément G, Wirth T, Haumesser L, Santin MDN, Voirin J, Lagha-Boukbiza O, Labonne C, Tranchant C, Longato N, Phillipps C, Anheim M. Language and verbal fluency outcome after bilateral subthalamic Nucleus Deep Brain Stimulation in Parkinson's disease. Parkinsonism Relat Disord 2022; 105:15-18. [PMID: 36327600 DOI: 10.1016/j.parkreldis.2022.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 10/18/2022] [Accepted: 10/23/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Language disorders in Parkinson's Disease (PD) following bilateral subthalamic Nucleus Deep Brain Stimulation (STN-DBS) are common. OBJECTIVE To assess STN-DBS impact on language and observe clinical and anatomical predictors of poor outcome. METHODS We prospectively included PD patients undergoing STN-DBS. We performed a neuropsychological evaluation focusing on language before (V0), 3 days after (V1), and 3 months after (V2) surgery. Patients performed all assessments in ON drug condition, V1 with the stimulation turned OFF to evaluate the lesion effect, and V2 with the stimulation turned ON to evaluate the stimulation effect. Electrodes and active contact locations were determined with MRI-Atlas fusion. The stimulation parameters and the total electrical energy delivered (TEED) were recorded for each patient. RESULTS 18 PD patients consecutively operated were included. We identified a decline in phonemic verbal fluency (VFP) at V1 and V2 (p = 0.023 and 0.032 respectively), as well as in semantic verbal fluency (VFS) (p = 0.025 and 0.019, respectively). There was a significant slowdown in the verbs naming test (p = 0.048). No other language alteration was recorded. There was no correlation between demographic or clinical factors and verbal fluency (VF) evolution. Active contact location within substantia nigra was associated with VFP worsening (p = 0.047), while elevated TEED on the left-sided electrode was associated with VFS decline (p = 0.021). CONCLUSION VF was significantly altered following STN-DBS. Location outside the dorsolateral sensorimotor STN, and high stimulation power appeared to promote this decline. Other language domains remained stable.
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Affiliation(s)
- Guillemette Clément
- Service de Neurologie, Centre de Référence Neurogénétique, Centre Expert Parkinson, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Thomas Wirth
- Service de Neurologie, Centre de Référence Neurogénétique, Centre Expert Parkinson, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Inserm-U964/CNRS-UMR7104/, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg, Illkirch, France; Fédération de Médecine Translationnelle de Strasbourg (FMTS), France
| | - Lucile Haumesser
- Pôle de Santé Publique, Groupe Méthode en Recherche Clinique, CHU de Strasbourg, France
| | | | - Jimmy Voirin
- Service de Neurochirurgie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Ouhaid Lagha-Boukbiza
- Service de Neurologie, Centre de Référence Neurogénétique, Centre Expert Parkinson, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Céline Labonne
- Service de Neurologie, Centre de Référence Neurogénétique, Centre Expert Parkinson, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Christine Tranchant
- Service de Neurologie, Centre de Référence Neurogénétique, Centre Expert Parkinson, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Inserm-U964/CNRS-UMR7104/, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg, Illkirch, France; Fédération de Médecine Translationnelle de Strasbourg (FMTS), France
| | - Nadine Longato
- Service de Neurologie, Centre de Référence Neurogénétique, Centre Expert Parkinson, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Inserm-U964/CNRS-UMR7104/, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg, Illkirch, France
| | - Clélie Phillipps
- Service de Neurologie, Centre de Référence Neurogénétique, Centre Expert Parkinson, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Inserm-U964/CNRS-UMR7104/, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg, Illkirch, France
| | - Mathieu Anheim
- Service de Neurologie, Centre de Référence Neurogénétique, Centre Expert Parkinson, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Inserm-U964/CNRS-UMR7104/, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg, Illkirch, France; Fédération de Médecine Translationnelle de Strasbourg (FMTS), France.
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Saleh C, Meyer A, Chaturvedi M, Beltrani S, Gschwandtner U, Fuhr P. Does Quantitative Electroencephalography Refine Preoperative Cognitive Assessment in Parkinson's Disease Patients Treated with Deep Brain Stimulation? A Follow-Up Study. Dement Geriatr Cogn Disord 2021; 50:349-356. [PMID: 34569496 DOI: 10.1159/000519053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/30/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Deep brain stimulation (DBS) in Parkinson's disease (PD) is associated with an increased risk of post-operative cognitive deterioration. Preoperative neuropsychological testing can be affected and limited by the patient's collaboration in advanced disease. The purpose of this study was to determine whether preoperative quantitative electroencephalography (qEEG) may be a useful complementary examination technique during preoperative assessment to predict cognitive changes in PD patients treated with DBS. METHODS We compared the cognitive performance of 16 PD patients who underwent bilateral subthalamic nucleus DBS to the performance of 15 PD controls (matched for age, sex, and education) at baseline and at 24 months. Cognitive scores were calculated for all patients across 5 domains. A preoperative 256-channel resting EEG was recorded from each patient. We computed the global relative power spectra. Correlation and linear regression models were used to assess associations of preoperative EEG measures with post-operative cognitive scores. RESULTS Slow waves (relative delta and theta band power) were negatively correlated with post-operative cognitive performance, while faster waves (alpha 1) were strongly positively correlated with the same scores (the overall cognitive score, attention, and executive function). Linear models revealed an association of delta power with the overall cognitive score (p = 0.00409, adjusted R2 = 0.6341). Verbal fluency (VF) showed a significant decline after DBS surgery, which was correlated with qEEG measures. CONCLUSIONS To analyse the side effects after DBS in PD patients, the most important parameter is verbal fluency capacity. In addition, correlation with EEG frequency bands might be useful to detect particularly vulnerable patients for cognitive impairment and be supportive in the selection process of patients considered for DBS.
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Affiliation(s)
- Christian Saleh
- Department of Neurophysiology and Neurology, University Hospital Basel, Basel, Switzerland
| | - Antonia Meyer
- Department of Neurophysiology and Neurology, University Hospital Basel, Basel, Switzerland
| | - Menorca Chaturvedi
- Department of Neurophysiology and Neurology, University Hospital Basel, Basel, Switzerland
| | - Selina Beltrani
- Department of Neurophysiology and Neurology, University Hospital Basel, Basel, Switzerland
| | - Ute Gschwandtner
- Department of Neurophysiology and Neurology, University Hospital Basel, Basel, Switzerland
| | - Peter Fuhr
- Department of Neurophysiology and Neurology, University Hospital Basel, Basel, Switzerland
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