3.8 Article

Five-year follow-up of unilateral posteroventral pallidotomy in Parkinson's disease

Journal

SURGICAL NEUROLOGY
Volume 71, Issue 5, Pages 551-558

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.surneu.2008.03.039

Keywords

Parkinson's disease; Posteroventral pallidotomy; Neuropsychology; Cognition

Funding

  1. NINDS NIH HHS [K23 NS041254-01A1, K23 NS041254] Funding Source: Medline

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Background: Neurocognitive outcome research of individuals with Parkinson's disease after unilateral pallidotomy is inconsistent. Although some studies reported few cognitive changes, other investigations have more consistently shown both transient and long-term cognitive decline postoperatively. Methods: We report the long-term motor and neurocognitive outcome 5 Wars Post surgery for 18 patients with Parkinson's disease (12 men and 6 woman; all right-handed) who underwent right or left Unilateral posteroventral pallidotomy. Results: Pallidotomy patients revealed long-term motor benefits from the surgery in their off state and control of dopa-induced dyskinesias in their on state, which is consistent with previous research, We found mild declines in oral and visuomotor information processing speed, verbal recognition memory, and mental slants 5 years after surgery, which differs front previous literature regarding the long-term neurocognitive outcome after pallidotomy. Differences between the right and left pallidotomy patients for both motor and cognitive skills were not found. Conclusion: Although deep brain stimulation is presently the treatment of choice, pallidotomy continues to be performed around the world. consequently, although unilateral pallidotomy should be considered a treatment option for patients with Parkinson's disease who suffer from severe Unilateral disabling motor symptoms or dyskinesias, the long-term neurocognitive outcome should also be considered in treatment decisions. (C) 2009 Elsevier Inc. All rights reserved.

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