Unilateral pallidotomy for Parkinson's disease: speech, motor, and neuropsychological outcome measurements

We studied the effects of unilateral medial pallidotomy in the first 57 con secutive Parkinson's disease (PD) patients undergoing this MRI/electrophysi ologically guided procedure at our institution, obtaining qualitative and q uantitative measures of speech. motor function, activities of daily living, and neuropsychological functioning at 3 and 12 months post-operatively. Sp eech intelligibility was typically preserved, declining mildly in one-third of patients post-operatively. Pallidotomy significantly improved motor fun ction similarly in patients greater than or equal to 65 or <65 years (n = 2 0). Cognitive abilities generally remained stable following surgery; howeve r, performance on measures of letter fluency and semantic fluency declined in patients with left pallidotomies. We conclude that in our series mild de terioration in speech may occur with unilateral pallidotomy in patients oth erwise responsive to this treatment. (C) 2000 Elsevier Science Ltd. All rig hts reserved.