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August 1997

Cognitive Sequelae of Unilateral Posteroventral Pallidotomy

Author Affiliations

From the Departments of Neurology (Drs Soukup, Schiess, and Calverley) and Psychiatry and Behavioral Sciences (Dr Ingram) and the Division of Neurosurgery, Department of Surgery (Drs Bonnen and Nauta), University of Texas Medical Branch, Galveston.

Arch Neurol. 1997;54(8):947-950. doi:10.1001/archneur.1997.00550200015004

Objective:  To examine the cognitive sequelae of unilateral posteroventral pallidotomy.

Design:  Single-group pretest and posttest methodologic assessment with baseline evaluation performed 1 to 2 days prior to surgery and follow-up conducted 3 months after pallidotomy.

Setting:  Movement disorder clinic at a university medical center.

Patients:  Fourteen patients (age range, 43-82 years) with Parkinson disease (average disease duration, 7.4 years).

Intervention:  Unilateral posteroventral pallidotomy procedures were performed on the right (n=8) and left (n=6) side of the brain.

Main Outcome Measures:  The protocol consisted of a range of neuropsychological instruments sensitive to subcortical dysfunction, including measures of bimanual coordination, simple-complex reaction time, visual attention, naming, verbal fluency, learning, recognition memory, and problem solving.

Results:  No significant deterioration in specific cognitive abilities was observed as a function of the procedure. Patients showed a significant improvement in motor coordination speed for both contralateral and ipsilateral upper extremities.

Conclusions:  Stereotactic unilateral posteroventral pallidotomy is associated with minimal risk of adverse neuropsychological effects or cognitive decline. Additional research is warranted, with an increased sample size and extended follow-up, to assess any potential lateralized effects of the procedure.

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