| Predictors of neuropsychological outcome in patients following microelectrode-guided pallidotomy for Parkinson's disease. | |
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MedLine Citation:
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PMID: 10969938 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECT: The authors studied neuropsychological performance following microelectrode-guided posteroventral pallidotomy in patients with Parkinson's disease (PD) and evaluated correlations with presurgical and surgical factors. METHODS: Neuropsychological changes 3 months (43 patients) and 12 months (27 patients) after microelectrode-guided pallidotomy for PD are reported in a series of 44 consecutive patients with the disease, who improved neurologically, as measured by the Unified Parkinson's Disease Rating Scale (UPDRS) in both the "off' (p<0.001) and best "on" (p<0.001) states. Findings of the vocabulary subtest of the Wechsler Adult Intelligence Scale-Revised (p<0.01), Letter Fluency (p<0.001), Verbal Fluency for semantic categories (p<0.001), and the Wisconsin Card Sorting Test (p<0.01) showed a significant decline in neuropsychological performance in patients 3 months after undergoing left-sided pallidotomy. Impairment in the language domain (semantic fluency) persisted at the 12-month follow-up examination (p<0.01). Visual memory improved after right-sided pallidotomies (p<0.01 after 3 months), with a nonsignificant trend toward persistent improvement 1 year postsurgery (p<0.02 after 12 months). Preoperative semantic fluency was influenced by patient age (p<0.001) and by the width of the third ventricle (p<0.05), as measured by magnetic resonance imaging. A regression model revealed that semantic fluency 3 months postoperatively was significantly affected by the baseline score (p<0.001), side of surgery (p<0.001), handedness (p<0.01), and patient age (p<0.05). However, postoperative lesion volume, lesion location, number of tracks, number of lesions, distance from anatomical landmarks, or UPDRS score did not significantly contribute to neuropsychological outcome. CONCLUSIONS: Neuropsychological changes in a cohort of patients with PD who underwent pallidotomy and experienced excellent clinical benefits and minimum postoperative complications, emphasize the importance of neuropsychological examinations and further investigation of predictive factors. |
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Authors:
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A A Obwegeser; R J Uitti; J A Lucas; R J Witte; M F Turk; R E Wharen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neurosurgery Volume: 93 ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 2000 Sep |
Date Detail:
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Created Date: 2000-09-14 Completed Date: 2000-09-14 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 410-20 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurosurgery, Mayo Clinic Jacksonville, Florida, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cognition* Cohort Studies Female Globus Pallidus / surgery* Humans Intelligence Tests Language Male Middle Aged Neuropsychological Tests Parkinson Disease / psychology, surgery* Predictive Value of Tests Treatment Outcome |
| Comments/Corrections | |
Comment In:
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J Neurosurg. 2000 Sep;93(3):527-8
[PMID:
10969962
]
J Neurosurg. 2001 May;94(5):866-8 [PMID: 11354429 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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