Abstract
OBJECTIVETo assess the long term cognitive outcome of unilateral posteroventral pallidotomy (PVP) and the overall efficacy of the surgery.METHODSForty two (29 left and 13 right PVP) patients with Parkinson's disease...
Highlights
Our patients showed a transient decline in learning verbal material 3 months post-posteroventral pallidotomy (PVP), with this deficit returning to baseline scores by the 12 month evaluation
This finding of cognitive decline after unilateral PVP is generally consistent with previous reports of neuropsychological outcome after PVP.[11 12]
When three patients who had adverse events on postoperative imaging studies were excluded from the analysis, a decline in verbal fluency performance after PVP was not found to be significant
Summary
Patients were considered eligible for PVP if: (1) their clinical findings were consistent with idiopathic Parkinson’s disease; (2) they had a history of response to levodopa therapy; and (3) they had evidence of advanced disease (disabling motor fluctuations, levodopa induced dyskinesias, or freezing, and a Hoehn and Yahr Parkinson’s disease staging score of 3 or more during their oV period).[17 18]. The first 42 consecutive patients who underwent neuropsychological testing preoperatively, and at 3 months and 12 months post-PVP were included in the study. All 42 patients (23 men and 19 women) were right handed and had advanced idiopathic Parkinson’s disease based on clinical symptoms and neurological examination. The patients with right or left PVP did not diVer significantly from each other on any demographic or neurological variables. One patient had had an adrenal implant to the right caudate nucleus nine years before his PVP; the second patient had had a left frontal ventriculoperitoneal shunt for hydrocephalus due to aqueductal stenosis, 10 years before PVP
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