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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Pallidal stimulation for primary generalised dystonia: Effect on cognition, mood and quality of life
Journal of Neurology, Volume 261, No. 1, Year 2014
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Description
We investigated the effect of pallidal deep brain stimulation (GPi-DBS) in dystonia on cognition, mood, and quality of life and also assessed if DYT1 gene status influenced cognitive outcome following GPi-DBS. Fourteen patients with primary generalized dystonia (PGD) were assessed, measuring their estimated premorbid and current IQ, memory for words and faces, and working memory, language, executive function, and sustained attention, one month before and one year or more after surgery. Changes in mood and behaviour and quality of life were also assessed. There was a significant improvement of dystonia with GPi-DBS (69 % improvement in Burke-Fahn-Marsden score, p < 0.0001). Performance on five cognitive tests either improved or declined at post-surgical follow-up. Calculation of a reliable change index suggested that deterioration in sustained attention on the PASAT was the only reliable change (worse after surgery) in cognition with GPi-DBS. DYT1 gene status did not influence cognitive outcome following GPi-DBS. Depression, anxiety and apathy were not significantly altered, and ratings of health status on the EQ5D remained unchanged. In our sample, GPi-DBS was only associated with an isolated deficit on a test of sustained attention, confirming that GPi-DBS in PGD is clinically effective and safe, without adverse effects on the main domains of cognitive function. The dissociation between GPi-DBS improving dystonia, but not having a significant positive impact on the patients' QoL, warrants further investigation. © 2013 The Author(s).
Authors & Co-Authors
Jahanshahi, Marjan
United Kingdom, London
National Hospital for Neurology and Neurosurgery
Torkamani, Mariam
United Kingdom, London
National Hospital for Neurology and Neurosurgery
Beigi, Mazda
United Kingdom, London
National Hospital for Neurology and Neurosurgery
Wilkinson, Leonora
United Kingdom, London
National Hospital for Neurology and Neurosurgery
United States, Bethesda
National Institute of Neurological Disorders and Stroke
Page, Donna
United Kingdom, London
National Hospital for Neurology and Neurosurgery
South Africa
Ballito Medical Center
Madeley, Laura
United Kingdom, London
National Hospital for Neurology and Neurosurgery
United Kingdom, London
Newham University Hospital
Bhatia, Kailash P.
United Kingdom, London
National Hospital for Neurology and Neurosurgery
Hariz, Marwan
United States, Bethesda
National Institute of Neurological Disorders and Stroke
Zrinzo, Ludvic
United Kingdom, London
National Hospital for Neurology and Neurosurgery
Limousin, Patricia Dowsey
United Kingdom, London
National Hospital for Neurology and Neurosurgery
Ruge, Diane
United Kingdom, London
National Hospital for Neurology and Neurosurgery
Tisch, Stephen
United Kingdom, London
National Hospital for Neurology and Neurosurgery
Australia, Sydney
St. Vincent's Hospital Sydney
Statistics
Citations: 49
Authors: 12
Affiliations: 5
Identifiers
Doi:
10.1007/s00415-013-7161-2
ISSN:
03405354
e-ISSN:
14321459
Research Areas
Disability
Genetics And Genomics
Health System And Policy
Mental Health
Study Design
Cohort Study