TY - JOUR
T1 - Pulse width is associated with cognitive decline after thalamic stimulation for essential tremor
AU - Woods, Steven Paul
AU - Fields, Julie A.
AU - Lyons, Kelly E.
AU - Pahwa, Rajesh
AU - Tröster, Alexander I.
PY - 2003/6
Y1 - 2003/6
N2 - The present study sought to identify predictors of cognitive decline after thalamic deep brain stimulation (DBS) for essential tremor (ET). Twenty-seven patients (55%) with ET demonstrated mild cognitive decrements relative to pre-surgical baseline (ET-D), whereas 22 patients (45%) were classified as neuropsychologically stable (ET-S). The ET-D and ET-S groups were comparable in terms of baseline demographic, disease, and neuropsychological characteristics, as well as post-surgical motor outcomes. However, the ET-D group had significantly higher pulse width (PW) stimulator settings, and a greater proportion of ET-D than ET-S patients underwent left in comparison to right thalamic stimulation. A subsequent step-wise discriminant function analysis revealed that disease onset after age 37 years and higher PW settings (≥120 μs) were the strongest predictors of post-surgical cognitive decline in this sample. Findings indicate that although relatively higher PW settings might afford optimal tremor control in some patients, the corresponding risk of mild, probably often subclinical, cognitive morbidity must be weighed accordingly.
AB - The present study sought to identify predictors of cognitive decline after thalamic deep brain stimulation (DBS) for essential tremor (ET). Twenty-seven patients (55%) with ET demonstrated mild cognitive decrements relative to pre-surgical baseline (ET-D), whereas 22 patients (45%) were classified as neuropsychologically stable (ET-S). The ET-D and ET-S groups were comparable in terms of baseline demographic, disease, and neuropsychological characteristics, as well as post-surgical motor outcomes. However, the ET-D group had significantly higher pulse width (PW) stimulator settings, and a greater proportion of ET-D than ET-S patients underwent left in comparison to right thalamic stimulation. A subsequent step-wise discriminant function analysis revealed that disease onset after age 37 years and higher PW settings (≥120 μs) were the strongest predictors of post-surgical cognitive decline in this sample. Findings indicate that although relatively higher PW settings might afford optimal tremor control in some patients, the corresponding risk of mild, probably often subclinical, cognitive morbidity must be weighed accordingly.
KW - Deep brain stimulation
KW - Essential tremor
KW - Neuropsychology
KW - Thalamus
UR - http://www.scopus.com/inward/record.url?scp=0038360743&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0038360743&partnerID=8YFLogxK
U2 - 10.1016/S1353-8020(03)00014-2
DO - 10.1016/S1353-8020(03)00014-2
M3 - Article
C2 - 12781597
AN - SCOPUS:0038360743
SN - 1353-8020
VL - 9
SP - 295
EP - 300
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
IS - 5
ER -