Deep brain stimulation effects on verbal fluency dissociated by target and active contact location
Open Access
- 17 February 2021
- journal article
- research article
- Published by Wiley in Annals of Clinical and Translational Neurology
- Vol. 8 (3), 613-622
- https://doi.org/10.1002/acn3.51304
Abstract
Objective Deep brain stimulation (DBS) improves motor symptoms in Parkinson’s disease (PD), but it can also disrupt verbal fluency with significant costs to quality of life. The current study investigated how variability of bilateral active electrode coordinates along the superior/inferior, anterior/posterior, and lateral/medial axes in the subthalamic nucleus (STN) or the globus pallidus interna (GPi) contribute to changes in verbal fluency. We predicted that electrode location in the left hemisphere would be linked to changes in fluency, especially in the STN. Methods Forty PD participants treated with bilateral DBS targeting STN (n = 23) or GPi (n = 17) completed verbal fluency testing in their optimally treated state before and after DBS therapy. Normalized atlas coordinates from left and right active electrode positions along superior/inferior, anterior/posterior, and lateral/medial axes were used to predict changes in fluency postoperatively, separately for patients with STN and GPi targets. Results Consistent with prior studies, fluency significantly declined pre‐ to postsurgery (in both DBS targets). In STN‐DBS patients, electrode position along the inferior to superior axis in the left STN was a significant predictor of fluency changes; relatively more superior left active electrode was associated with the largest fluency declines in STN. Electrode coordinates in right STN or GPi (left or right) did not predict fluency changes. Interpretation We discuss these findings in light of putative mechanisms and potential clinical impact.Keywords
Funding Information
- National Institute of Neurological Disorders and Stroke (RO1NS095291)
This publication has 58 references indexed in Scilit:
- Relation of lead trajectory and electrode position to neuropsychological outcomes of subthalamic neurostimulation in Parkinson’s disease: results from a randomized trialBrain, 2013
- CranialVault and its CRAVE tools: A clinical computer assistance system for deep brain stimulation (DBS) therapyMedical Image Analysis, 2012
- Cognitive outcome and reliable change indices two years following bilateral subthalamic nucleus deep brain stimulationParkinsonism & Related Disorders, 2011
- The trajectory of apathy after deep brain stimulation: From pre-surgery to 6 months post-surgery in Parkinson’s diseaseParkinsonism & Related Disorders, 2011
- Patient-specific analysis of the relationship between the volume of tissue activated during DBS and verbal fluencyNeuroImage, 2011
- Customized, Miniature Rapid-Prototype Stereotactic Frames for Use in Deep Brain Stimulator Surgery: Initial Clinical Methodology and Experience from 263 Patients from 2002 to 2008Stereotactic and Functional Neurosurgery, 2010
- Relationship between neuropsychological outcome and DBS surgical trajectory and electrode locationJournal of the Neurological Sciences, 2009
- Cognitive declines one year after unilateral deep brain stimulation surgery in parkinson's disease: A controlled study using reliable changeThe Clinical Neuropsychologist, 2009
- Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE TrialAnnals of Neurology, 2009
- Neuropsychological functioning following bilateral subthalamic nucleus stimulation in Parkinson's diseaseArchives of Clinical Neuropsychology, 2004