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Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia

OBJECTIVE: Subthalamic nucleus (STN) deep brain stimulation (DBS) can improve motor complications of Parkinson's disease (PD) but may worsen specific cognitive functions. The effect of STN DBS on cognitive function in dystonia patients is less clear. Previous reports indicate that bilateral STN...

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Autores principales: Mills, Kelly A, Markun, Leslie C, Luciano, Marta San, Rizk, Rami, Allen, I Elaine, Racine, Caroline A, Starr, Philip A, Alberts, Jay L, Ostrem, Jill L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392192/
https://www.ncbi.nlm.nih.gov/pubmed/25012202
http://dx.doi.org/10.1136/jnnp-2014-307942
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author Mills, Kelly A
Markun, Leslie C
Luciano, Marta San
Rizk, Rami
Allen, I Elaine
Racine, Caroline A
Starr, Philip A
Alberts, Jay L
Ostrem, Jill L
author_facet Mills, Kelly A
Markun, Leslie C
Luciano, Marta San
Rizk, Rami
Allen, I Elaine
Racine, Caroline A
Starr, Philip A
Alberts, Jay L
Ostrem, Jill L
author_sort Mills, Kelly A
collection PubMed
description OBJECTIVE: Subthalamic nucleus (STN) deep brain stimulation (DBS) can improve motor complications of Parkinson's disease (PD) but may worsen specific cognitive functions. The effect of STN DBS on cognitive function in dystonia patients is less clear. Previous reports indicate that bilateral STN stimulation in patients with PD amplifies the decrement in cognitive-motor dual-task performance seen when moving from a single-task to dual-task paradigm. We aimed to determine if the effect of bilateral STN DBS on dual-task performance in isolated patients with dystonia, who have less cognitive impairment and no dementia, is similar to that seen in PD. METHODS: Eight isolated predominantly cervical patients with dystonia treated with bilateral STN DBS, with average dystonia duration of 10.5 years and Montreal Cognitive Assessment score of 26.5, completed working memory (n-back) and motor (forced-maintenance) tests under single-task and dual-task conditions while on and off DBS. RESULTS: A multivariate, repeated-measures analysis of variance showed no effect of stimulation status (On vs Off) on working memory (F=0.75, p=0.39) or motor function (F=0.22, p=0.69) when performed under single-task conditions, though as working memory task difficulty increased, stimulation disrupted the accuracy of force-tracking. There was a very small worsening in working memory performance (F=9.14, p=0.019) when moving from single-task to dual-tasks when using the ‘dual-task loss’ analysis. CONCLUSIONS: This study suggests the effect of STN DBS on working memory and attention may be much less consequential in patients with dystonia than has been reported in PD.
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spelling pubmed-43921922015-04-13 Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia Mills, Kelly A Markun, Leslie C Luciano, Marta San Rizk, Rami Allen, I Elaine Racine, Caroline A Starr, Philip A Alberts, Jay L Ostrem, Jill L J Neurol Neurosurg Psychiatry Movement Disorders OBJECTIVE: Subthalamic nucleus (STN) deep brain stimulation (DBS) can improve motor complications of Parkinson's disease (PD) but may worsen specific cognitive functions. The effect of STN DBS on cognitive function in dystonia patients is less clear. Previous reports indicate that bilateral STN stimulation in patients with PD amplifies the decrement in cognitive-motor dual-task performance seen when moving from a single-task to dual-task paradigm. We aimed to determine if the effect of bilateral STN DBS on dual-task performance in isolated patients with dystonia, who have less cognitive impairment and no dementia, is similar to that seen in PD. METHODS: Eight isolated predominantly cervical patients with dystonia treated with bilateral STN DBS, with average dystonia duration of 10.5 years and Montreal Cognitive Assessment score of 26.5, completed working memory (n-back) and motor (forced-maintenance) tests under single-task and dual-task conditions while on and off DBS. RESULTS: A multivariate, repeated-measures analysis of variance showed no effect of stimulation status (On vs Off) on working memory (F=0.75, p=0.39) or motor function (F=0.22, p=0.69) when performed under single-task conditions, though as working memory task difficulty increased, stimulation disrupted the accuracy of force-tracking. There was a very small worsening in working memory performance (F=9.14, p=0.019) when moving from single-task to dual-tasks when using the ‘dual-task loss’ analysis. CONCLUSIONS: This study suggests the effect of STN DBS on working memory and attention may be much less consequential in patients with dystonia than has been reported in PD. BMJ Publishing Group 2015-04 2014-07-10 /pmc/articles/PMC4392192/ /pubmed/25012202 http://dx.doi.org/10.1136/jnnp-2014-307942 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Movement Disorders
Mills, Kelly A
Markun, Leslie C
Luciano, Marta San
Rizk, Rami
Allen, I Elaine
Racine, Caroline A
Starr, Philip A
Alberts, Jay L
Ostrem, Jill L
Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia
title Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia
title_full Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia
title_fullStr Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia
title_full_unstemmed Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia
title_short Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia
title_sort effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia
topic Movement Disorders
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392192/
https://www.ncbi.nlm.nih.gov/pubmed/25012202
http://dx.doi.org/10.1136/jnnp-2014-307942
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