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Pulse width is associated with cognitive decline after thalamic stimulation for essential tremor
Steven Paul Woods1, Julie A Fields, Kelly E Lyons
1Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Box 356560, 1959 NE Pacific Street, Seattle, WA 98195-6560, USA.
Parkinsonism & Related Disorders
|June 5, 2003
Summary
Higher pulse width settings during thalamic deep brain stimulation (DBS) for essential tremor (ET) may predict cognitive decline. This risk should be considered alongside potential tremor control benefits.
Area of Science:
- Neurosurgery
- Neurology
- Cognitive Science
Background:
- Essential tremor (ET) is a common neurological disorder.
- Thalamic deep brain stimulation (DBS) is an effective treatment for ET.
- Cognitive side effects after DBS for ET are a concern.
Purpose of the Study:
- To identify predictors of cognitive decline following thalamic DBS in ET patients.
- To compare cognitive outcomes between patients who declined cognitively and those who remained stable.
Main Methods:
- Retrospective analysis of 49 ET patients undergoing thalamic DBS.
- Neuropsychological testing pre- and post-surgery.
- Statistical analysis including discriminant function analysis to identify predictors.
Main Results:
- 55% of patients showed mild cognitive decrements post-surgery.
- Higher pulse width (PW) settings and disease onset after age 37 predicted cognitive decline.
- Left thalamic stimulation was more common in the cognitively declining group.
Conclusions:
- Higher PW settings, while potentially improving tremor control, are associated with an increased risk of mild cognitive decline.
- Disease onset age and specific stimulation parameters are crucial factors in predicting cognitive outcomes.
- The potential for cognitive morbidity should be carefully weighed against tremor benefits in thalamic DBS for ET.