Monitoring cognitive functions during deep brain stimulation (DBS) interventions by Real Time Neuropsychological Testing (DBS-RTNT).

IF 2.5 4区 医学 Q2 CLINICAL NEUROLOGY
Ilaria Guarracino, Christian Lettieri, Massimo Mondani, Stanislao D'Auria, Giovanni Sciacca, Flavia Lavezzi, Miran Skrap, Serena D'Agostini, Gian Luigi Gigli, Mariarosaria Valente, Barbara Tomasino
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引用次数: 0

Abstract

Objective: We monitored cognition during Deep brain stimulation (DBS) surgery, when the electrode is positioned at the target subthalamic nucleus (i.e., STN motor area) in 14 PD patients.

Methods: We present the Real Time Neuropsychological Testing (DBS-RTNT) protocol, our preliminary experience, along with patients' performance comparing intraoperative results with baseline data.

Results: Compared to baseline, DBS-RTNT in the target area showed a significantly decreased performance at some tasks belonging to memory and executive functions domains. Significantly decreased short-term memory and sequencing scores were found for right (vs. left) hemisphere DBS-RTNT.

Conclusions: PD patients' performance should be monitored during DBS surgery as STN-DBS may induce changes in cognitive performance. These preliminary data contribute to improve, during DBS-surgery the anatomo-functional topography of the STN in order to identify, in future approaches, in the individual patient the best site producing positive motor effects, without causing negative cognitive and/or emotional changes. Medications (i.e., the patients underwent surgery in a levodopa off state) could in principle have influenced our results therefore future studies are needed to address possible confounding effect of levodopa use.

通过实时神经心理测试(DBS-RTNT)监测深部脑刺激(DBS)干预期间的认知功能。
目的在对14名帕金森病患者进行深部脑刺激(DBS)手术时,当电极位于目标丘脑下核(即STN运动区)时,我们对患者的认知能力进行了监测:我们介绍了实时神经心理测试(DBS-RTNT)方案、我们的初步经验以及患者的表现,并将术中结果与基线数据进行了比较:结果:与基线数据相比,靶区的 DBS-RTNT 在记忆和执行功能领域的一些任务中表现出明显的下降。右(与左)半球 DBS-RTNT 的短时记忆和排序得分显著下降:结论:由于STN-DBS可能会引起认知能力的改变,因此在DBS手术期间应监测帕金森病患者的表现。这些初步数据有助于在 DBS 手术期间改善 STN 的解剖功能地形图,以便在未来的方法中确定对患者产生积极运动效应的最佳部位,同时不会引起负面的认知和/或情绪变化。药物(即患者在停用左旋多巴的状态下接受手术)原则上可能会影响我们的结果,因此未来的研究需要解决左旋多巴使用可能造成的混淆效应。
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来源期刊
Journal of Movement Disorders
Journal of Movement Disorders CLINICAL NEUROLOGY-
CiteScore
2.50
自引率
5.10%
发文量
49
审稿时长
12 weeks
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