Summary: A recent study has demonstrated that right-sided unilateral deep brain stimulation ( DBS ) on the right side of the brain ameliorates motor symptoms in Parkinson’s patients without causing significant declines in verbal fluency. According to research, term technology and searching decreased more significantly with DBS on the left hemispheres.
The findings suggest that punitive DBS, which targets both brain hemispheres, may be preferable to the standard bilateral approach. This finding was help Parkinson’s patients get more precisely treated while preserving mental functions like speech.
Important Facts:
- Right-side DBS improves motor signs without harming linguistic competency.
- Left-side DBS causes declines in rhetorical fluency and answer restriction.
- Unilateral DBS does provide a safer alternative to diplomatic excitement for Parkinson’s patients.
Origin: University of Alabama at Birmingham
Deep brain stimulation is a successful cure for machine symptoms in people with motion disorders like Parkinson’s disease. DBS can result in apparent falls in verbal competence, which has an impact on how quickly terms can be retrieved and generated, despite eventually being regarded as safe.
Analysts at the , University of Alabama at Birmingham , studied the effects of punitive DBS on verbal fluency in Parkinson’s patients. Findings revealed that cathode implants in the left hemisphere of the head appeared to be the main factor in the decline in verbal fluency in individuals who had undergone DBS operation.
The study was part of the National Institutes of Health ‘s , Brain Research through Advancing Innovative Neurotechnologies ® Initiative, or The BRAIN Initiative®, and results were , published in the Annals of Neurology.
” Patients who received right-sided DBS implants really showed mild changes in verbal fluency performance over the time period of the investigation”, said , Victor Del Bene, Ph. D., a neurologist in the UAB , Department of Neurology , and head writer.
Usually, DBS involves placing tiny wires wires symmetrically, on both sides of the brain, in people with Parkinson’s disorder. However, motor signs from Parkinson’s condition are asymmetrical at beginnings, which means they affect one side of the brain more than the other.
Surgeons at , UAB Medicine , have used punitive excitement on the most afflicted side of the brain as a less aggressive, alternative solution for DBS treatment.
” We found that punitive treatment significantly improves engine symptoms for years, with the opportunity to deal with DBS on the opposite side of the brain if and when it is needed”, said , Harrison Walker, M. D., teacher in the UAB Department of Neurology. Despite this, much is known about how punitive DBS affects these people ‘ ability to communicate and perform various cognitive functions.
The findings of the study suggest that punitive proper DBS may prevent DBS-related falls in linguistic fluency and answer inhibition in patients with motion diseases like Parkinson’s disease by stimulating both sides of the brain.
Also, it appeared to be no DBS-related continent differences in terms of fast or delayed remember of linguistic details, despite the findings that the left hemisphere excitement was associated with greater declines in response inhibition.
” We hope these results will persuade neurologists and neurosurgeons at other medical centers that unilateral DBS on the most severely affected side of the brain has advantages over the more invasive bilateral option for therapy,” said Walker.
” In particular, unilateral right hemisphere stimulation may prevent sporadic declines in some cognitive functions that come with the bilateral DBS intervention.”
The results of this study are from the , NIH BRAIN Initiative , grant awarded to UAB in 2016. The team included researchers from the UAB Departments of Neurology,  , Neurosurgery , and , Physical Therapy, as well as the , School of Public Health. With a new BRAIN Initiative grant that Walker and his team have obtained, the researchers intend to expand on these findings.
Funding: The BRAIN Initiative® is a registered trademark of the U. S. Department of Health and Human Services. The authors are solely responsible for the content, which does not necessarily reflect the National Institutes of Health’s official position. The NIH BRAIN Initiative supported the research presented in this study under award number ( UH3-NS100553 ).
About this Parkinson’s disease and DBS research news
Author: Katherine Gaither
Source: University of Alabama at Birmingham
Contact: Katherine Gaither – University of Alabama at Birmingham
Image: The image is credited to Neuroscience News
Original Research: Open access.
Victor Del Bene and colleagues ‘” Differential Cognitive Effects of Unilateral Subthalamic Nucleus Deep Brain Stimulation for Parkinson’s Disease” are discussed. Annals of Neurology
Abstract
Differential Cognitive Benefits of Deep Brain Stimulation in Parkinson’s Disease from Unilateral Subthalamic Nucleus
Objective
In patients with advanced Parkinson’s disease, the purpose of this study was to examine the cognitive effects of unilateral directional versus ring subthalamic nucleus deep brain stimulation (STN DBS ).
Methods
We examined 31 participants who underwent unilateral STN DBS ( left , n = 17, right , n = 14 ) as part of an National Institutes of Health ( NIH) -sponsored randomized, double-blind, crossover study contrasting directional versus ring stimulation. In the hemisphere where motor parkinsonism is most severe, all participants received unilateral DBS implants. Measures of cognition included verbal fluency, auditory-verbal memory, and response inhibition. We compared the effects of directional versus ring stimulation and implant hemisphere on longitudinal cognitive function using mixed linear models.
Results
Crossover analyses found no evidence for directional versus ring stimulation-related cognitive performance changes at the group level. Implant hemisphere, however, impacted cognition in several ways. Left STN participants had lower baseline verbal fluency than patients with right implants ( t  ,]20.66 = −2.50,  , p = 0.02] ). Verbal fluency declined after left ( p = 0.013 ) but increased after right STN DBS ( p <, 0.001 ), and response inhibition was faster following right STN DBS ( p = 0.031 ). Regardless of hemisphere, delayed recall declined modestly over time versus baseline ( p = 0.001 ), and immediate recall was unchanged.
Interpretation
Directional versus ring STN DBS did not have a different impact on cognition. Similar to prior bilateral DBS studies, unilateral left stimulation worsened verbal fluency performance. In contrast, unilateral right STN surgery improved verbal fluency and response-inhibition tests. Our findings support the hypothesis that unilateral right-sensing DBS in some patients with predominate right brain motor dysfunction might help to prevent verbal fluency declines brought on by the bilateral intervention.
