A DGReview of :"A comparison of neuropsychological effects of thalamotomy and thalamic stimulation." - Neurology
By Anne MacLennan
Both thalamotomy and thalamic stimulation are linked with a minimal overall risk of cognitive deterioration in patients with severe drug-resistant tremor.
This is the chief conclusion of researchers in the Netherlands following a randomised comparison of the neuropsychological effects of these two approaches in patients with severe resistant tremor caused by Parkinson disease (PD), essential tremor (ET) or Multiple Sclerosis.
Verbal fluency decreased, however, after both left-sided thalamotomy and thalamic stimulation, report Dr P R Schuurman and colleagues from the Departments of Neurosurgery, Neurology and Clinical Epidemiology, Academic Medical Center, Amsterdam.
The researchers did complete neuropsychological evaluations at baseline and again at six months after surgery on 62 patients who had one or the other of these procedures for tremor.
Thirty-two of the patients, 21 with PD, six with ET and five with MS, underwent thalamotomy. The other 30 underwent thalamic stimulation (19 PD, seven ET and four MS).
Six months after the thalamotomy, there was a decline in the scores of the Stroop Color-Word Test, with the exception of the interference score.
In the thalamic stimulation group, no significant changes were found on any of the cognitive tests.
After both thalamotomy and thalamic stimulation, study indicated there was a difference in score changes between right- and left-sided surgery in verbal fluency and Stroop Test scores.
Age, diagnosis, disease severity and baseline cognitive status were not correlated to cognitive changes, the researchers point out.
Neurology 2002 Oct 22;59(8):1232-9. "A
comparison of neuropsychological effects of thalamotomy and thalamic stimulation."
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