COGNITIVE-FUNCTIONING AFTER PALLIDOTOMY FOR REFRACTORY PARKINSONS-DISEASE

Background-Earlier approaches to pallidotomy for refractory Parkinson' s disease had significant complication rates. More recent approaches s how fewer complications, but the effect of pallidotomy on cognition is unclear. The current study was conducted to examine the neuropsycholo gical effects of unilateral pallidotomy. Methods-Neuropsychological te sting was performed on patients with medically refractory, predominant ly unilateral Parkinson's disease at baseline and after unilateral ven tral pallidotomy (n=28) or after an equivalent period without surgery in control patients (n=10). Results-Pallidotomy patients showed no sig nificant changes from baseline to retesting relative to the control gr oup for any measure. Across all of the tests administered, only five o f the surgery patients showed a significant decline, and of these five none declined on more than one test. Depression did not relate to pre operative or postoperative cognition. The pallidotomy group showed a s ignificant improvement in motor functioning and activities of daily li ving whereas the control group did not. These measures were not associ ated with the neuropsychological test scores at baseline or retest. Co nclusions-Stereotactic unilateral ventral pallidotomy does not seem to produce dramatic cognitive declines in most patients.