Globus pallidal deep brain stimulation for Tourette syndrome: Effects on cognitive function

Davide Cappon; Mazda Beigi; Zinovia Kefalopoulou; Ludvic Zrinzo; Joseph Candelario; Catherine Milabo; Harith Akram; Viswas Dayal; Jonathan Hyam; Lewis Kass-Iliyya; Monty Silverdale; Julian Evans; Patricia Limousin; Marwan Hariz; Eileen Joyce; Thomas Foltynie; Marjan Jahanshahi

doi:10.1016/j.parkreldis.2019.10.013

Globus pallidal deep brain stimulation for Tourette syndrome: Effects on cognitive function

Davide Cappon, Mazda Beigi, Zinovia Kefalopoulou, Ludvic Zrinzo, Joseph Candelario, Catherine Milabo, Harith Akram, Viswas Dayal, Jonathan Hyam, Lewis Kass-Iliyya, Monty Silverdale, Julian Evans, Patricia Limousin, Marwan Hariz, Eileen Joyce, Thomas Foltynie, Marjan Jahanshahi

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Abstract

INTRODUCTION: In a double-blind randomized crossover trial, we previously established that bilateral deep brain stimulation of the anteromedial globus pallidus internus (GPiam-DBS) is effective in significantly reducing tic severity in patients with refractory Tourette syndrome (TS). Here, we report the effects of bilateral GPiam-DBS on cognitive function in 11 of the 13 patients who had participated in our double-blind cross-over trial of GPi-DBS.

METHODS: Patients were assessed at baseline (4 weeks prior to surgery) and at the end of each of the three-month blinded periods, with stimulation either ON or OFF. The patients were evaluated on tests of memory (California Verbal Learning Test-II (CVLT-II); Corsi blocks; Short Recognition Memory for Faces), executive function (D-KEFS Stroop color-word interference, verbal fluency, Trail-making test, Hayling Sentence Completion test), and attention (Paced Auditory Serial Addition Test, Numbers and Letters Test).

RESULTS: GPiam-DBS did not produce any significant change in global cognition. Relative to pre-operative baseline assessment verbal episodic memory on the CVLT-II and set-shifting on the Trail-making Test were improved with DBS OFF. Performance on the cognitive tests were not different with DBS ON versus DBS OFF. GPiam-DBS did not alter aspects of cognition that are impaired in TS such as inhibition on the Stroop interference task or the Hayling Sentence Completion test.

CONCLUSIONS: This study extends previous findings providing data showing that GPiam-DBS does not adversely affect cognitive domains such as memory, executive function, verbal fluency, attention, psychomotor speed, and information processing. These results indicate that GPiam-DBS does not produce any cognitive deficits in TS.

Original language	English
Pages (from-to)	14-18
Number of pages	5
Journal	Parkinsonism & Related Disorders
Volume	69
Early online date	14 Oct 2019
DOIs	https://doi.org/10.1016/j.parkreldis.2019.10.013
Publication status	Published - Dec 2019

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TS_Manuscript_lastvAccepted author manuscript, 2.4 MBLicence: CC BY-NC-ND

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Cappon, D., Beigi, M., Kefalopoulou, Z., Zrinzo, L., Candelario, J., Milabo, C., Akram, H., Dayal, V., Hyam, J., Kass-Iliyya, L., Silverdale, M., Evans, J., Limousin, P., Hariz, M., Joyce, E., Foltynie, T., & Jahanshahi, M. (2019). Globus pallidal deep brain stimulation for Tourette syndrome: Effects on cognitive function. Parkinsonism & Related Disorders, 69, 14-18. https://doi.org/10.1016/j.parkreldis.2019.10.013

@article{3566dce0350e4bca878f4b9142bacdb4,

title = "Globus pallidal deep brain stimulation for Tourette syndrome: Effects on cognitive function",

abstract = "INTRODUCTION: In a double-blind randomized crossover trial, we previously established that bilateral deep brain stimulation of the anteromedial globus pallidus internus (GPiam-DBS) is effective in significantly reducing tic severity in patients with refractory Tourette syndrome (TS). Here, we report the effects of bilateral GPiam-DBS on cognitive function in 11 of the 13 patients who had participated in our double-blind cross-over trial of GPi-DBS.METHODS: Patients were assessed at baseline (4 weeks prior to surgery) and at the end of each of the three-month blinded periods, with stimulation either ON or OFF. The patients were evaluated on tests of memory (California Verbal Learning Test-II (CVLT-II); Corsi blocks; Short Recognition Memory for Faces), executive function (D-KEFS Stroop color-word interference, verbal fluency, Trail-making test, Hayling Sentence Completion test), and attention (Paced Auditory Serial Addition Test, Numbers and Letters Test).RESULTS: GPiam-DBS did not produce any significant change in global cognition. Relative to pre-operative baseline assessment verbal episodic memory on the CVLT-II and set-shifting on the Trail-making Test were improved with DBS OFF. Performance on the cognitive tests were not different with DBS ON versus DBS OFF. GPiam-DBS did not alter aspects of cognition that are impaired in TS such as inhibition on the Stroop interference task or the Hayling Sentence Completion test.CONCLUSIONS: This study extends previous findings providing data showing that GPiam-DBS does not adversely affect cognitive domains such as memory, executive function, verbal fluency, attention, psychomotor speed, and information processing. These results indicate that GPiam-DBS does not produce any cognitive deficits in TS.",

author = "Davide Cappon and Mazda Beigi and Zinovia Kefalopoulou and Ludvic Zrinzo and Joseph Candelario and Catherine Milabo and Harith Akram and Viswas Dayal and Jonathan Hyam and Lewis Kass-Iliyya and Monty Silverdale and Julian Evans and Patricia Limousin and Marwan Hariz and Eileen Joyce and Thomas Foltynie and Marjan Jahanshahi",

note = "Copyright {\textcopyright} 2019. Published by Elsevier Ltd.",

year = "2019",

month = dec,

doi = "10.1016/j.parkreldis.2019.10.013",

language = "English",

volume = "69",

pages = "14--18",

journal = "Parkinsonism & Related Disorders",

issn = "1353-8020",

publisher = "Elsevier BV",

}

Cappon, D, Beigi, M, Kefalopoulou, Z, Zrinzo, L, Candelario, J, Milabo, C, Akram, H, Dayal, V, Hyam, J, Kass-Iliyya, L, Silverdale, M, Evans, J, Limousin, P, Hariz, M, Joyce, E, Foltynie, T & Jahanshahi, M 2019, 'Globus pallidal deep brain stimulation for Tourette syndrome: Effects on cognitive function', Parkinsonism & Related Disorders, vol. 69, pp. 14-18. https://doi.org/10.1016/j.parkreldis.2019.10.013

TY - JOUR

T1 - Globus pallidal deep brain stimulation for Tourette syndrome

T2 - Effects on cognitive function

AU - Cappon, Davide

AU - Beigi, Mazda

AU - Kefalopoulou, Zinovia

AU - Zrinzo, Ludvic

AU - Candelario, Joseph

AU - Milabo, Catherine

AU - Akram, Harith

AU - Dayal, Viswas

AU - Hyam, Jonathan

AU - Kass-Iliyya, Lewis

AU - Silverdale, Monty

AU - Evans, Julian

AU - Limousin, Patricia

AU - Hariz, Marwan

AU - Joyce, Eileen

AU - Foltynie, Thomas

AU - Jahanshahi, Marjan

PY - 2019/12

Y1 - 2019/12

N2 - INTRODUCTION: In a double-blind randomized crossover trial, we previously established that bilateral deep brain stimulation of the anteromedial globus pallidus internus (GPiam-DBS) is effective in significantly reducing tic severity in patients with refractory Tourette syndrome (TS). Here, we report the effects of bilateral GPiam-DBS on cognitive function in 11 of the 13 patients who had participated in our double-blind cross-over trial of GPi-DBS.METHODS: Patients were assessed at baseline (4 weeks prior to surgery) and at the end of each of the three-month blinded periods, with stimulation either ON or OFF. The patients were evaluated on tests of memory (California Verbal Learning Test-II (CVLT-II); Corsi blocks; Short Recognition Memory for Faces), executive function (D-KEFS Stroop color-word interference, verbal fluency, Trail-making test, Hayling Sentence Completion test), and attention (Paced Auditory Serial Addition Test, Numbers and Letters Test).RESULTS: GPiam-DBS did not produce any significant change in global cognition. Relative to pre-operative baseline assessment verbal episodic memory on the CVLT-II and set-shifting on the Trail-making Test were improved with DBS OFF. Performance on the cognitive tests were not different with DBS ON versus DBS OFF. GPiam-DBS did not alter aspects of cognition that are impaired in TS such as inhibition on the Stroop interference task or the Hayling Sentence Completion test.CONCLUSIONS: This study extends previous findings providing data showing that GPiam-DBS does not adversely affect cognitive domains such as memory, executive function, verbal fluency, attention, psychomotor speed, and information processing. These results indicate that GPiam-DBS does not produce any cognitive deficits in TS.

AB - INTRODUCTION: In a double-blind randomized crossover trial, we previously established that bilateral deep brain stimulation of the anteromedial globus pallidus internus (GPiam-DBS) is effective in significantly reducing tic severity in patients with refractory Tourette syndrome (TS). Here, we report the effects of bilateral GPiam-DBS on cognitive function in 11 of the 13 patients who had participated in our double-blind cross-over trial of GPi-DBS.METHODS: Patients were assessed at baseline (4 weeks prior to surgery) and at the end of each of the three-month blinded periods, with stimulation either ON or OFF. The patients were evaluated on tests of memory (California Verbal Learning Test-II (CVLT-II); Corsi blocks; Short Recognition Memory for Faces), executive function (D-KEFS Stroop color-word interference, verbal fluency, Trail-making test, Hayling Sentence Completion test), and attention (Paced Auditory Serial Addition Test, Numbers and Letters Test).RESULTS: GPiam-DBS did not produce any significant change in global cognition. Relative to pre-operative baseline assessment verbal episodic memory on the CVLT-II and set-shifting on the Trail-making Test were improved with DBS OFF. Performance on the cognitive tests were not different with DBS ON versus DBS OFF. GPiam-DBS did not alter aspects of cognition that are impaired in TS such as inhibition on the Stroop interference task or the Hayling Sentence Completion test.CONCLUSIONS: This study extends previous findings providing data showing that GPiam-DBS does not adversely affect cognitive domains such as memory, executive function, verbal fluency, attention, psychomotor speed, and information processing. These results indicate that GPiam-DBS does not produce any cognitive deficits in TS.

U2 - 10.1016/j.parkreldis.2019.10.013

DO - 10.1016/j.parkreldis.2019.10.013

M3 - Article

C2 - 31648149

SN - 1353-8020

VL - 69

SP - 14

EP - 18

JO - Parkinsonism & Related Disorders

JF - Parkinsonism & Related Disorders

ER -

Globus pallidal deep brain stimulation for Tourette syndrome: Effects on cognitive function

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