Cognitive and psychiatric outcomes in the GALAXY trial: effect of anaesthesia in deep brain stimulation.

COGNITION ELECTRICAL STIMULATION NEUROPSYCHIATRY PARKINSON'S DISEASE

Journal

Journal of neurology, neurosurgery, and psychiatry
ISSN: 1468-330X
Titre abrégé: J Neurol Neurosurg Psychiatry
Pays: England
ID NLM: 2985191R

Informations de publication

Date de publication:
07 Sep 2023
Historique:
received: 04 05 2023
accepted: 23 08 2023
medline: 8 9 2023
pubmed: 8 9 2023
entrez: 7 9 2023
Statut: aheadofprint

Résumé

This study aims: (1) To compare cognitive and psychiatric outcomes after bilateral awake versus asleep subthalamic nucleus (STN) deep brain stimulation (DBS) surgery for Parkinson's disease (PD). (2) To explore the occurrence of psychiatric diagnoses, cognitive impairment and quality of life after surgery in our whole sample. (3) To validate whether we can predict postoperative cognitive decline. 110 patients with PD were randomised to receive awake (n=56) or asleep (n=54) STN DBS surgery. At baseline and 6-month follow-up, all patients underwent standardised assessments testing several cognitive domains, psychiatric symptoms and quality of life. There were no differences on neuropsychological composite scores and psychiatric symptoms between the groups, but we found small differences on individual tests and cognitive domains. The asleep group performed better on the Rey Auditory Verbal Learning Test delayed memory test ( This study suggests that the choice between awake and asleep STN DBS does not affect cognitive, mood and behavioural adverse effects, despite a minor difference in memory. STN DBS has a beneficial effect on quality of life, mood and anxiety symptoms. NTR5809.

Sections du résumé

BACKGROUND BACKGROUND
This study aims: (1) To compare cognitive and psychiatric outcomes after bilateral awake versus asleep subthalamic nucleus (STN) deep brain stimulation (DBS) surgery for Parkinson's disease (PD). (2) To explore the occurrence of psychiatric diagnoses, cognitive impairment and quality of life after surgery in our whole sample. (3) To validate whether we can predict postoperative cognitive decline.
METHODS METHODS
110 patients with PD were randomised to receive awake (n=56) or asleep (n=54) STN DBS surgery. At baseline and 6-month follow-up, all patients underwent standardised assessments testing several cognitive domains, psychiatric symptoms and quality of life.
RESULTS RESULTS
There were no differences on neuropsychological composite scores and psychiatric symptoms between the groups, but we found small differences on individual tests and cognitive domains. The asleep group performed better on the Rey Auditory Verbal Learning Test delayed memory test (
CONCLUSIONS CONCLUSIONS
This study suggests that the choice between awake and asleep STN DBS does not affect cognitive, mood and behavioural adverse effects, despite a minor difference in memory. STN DBS has a beneficial effect on quality of life, mood and anxiety symptoms.
TRIAL REGISTRATION NUMBER BACKGROUND
NTR5809.

Identifiants

pubmed: 37679030
pii: jnnp-2023-331791
doi: 10.1136/jnnp-2023-331791
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: RH and PvdM reported grants from Dutch Brain Foundation during the conduct of the study. DD received grants from ZonMw and Boston Scientific for a trial on deep brain stimulation for depression. RMADB reported grants from Hersenstichting Charitable Organization during the conduct of the study and grants from the Netherlands Organisation for Health Research and Development, Stichting Parkinson Nederland, GE Healthcare, Medtronic, Lysosomal Therapeutics and Neuroderm, all paid to institution, outside the submitted work. RS reported personal fees from Medtronic and Boston Scientific during the conduct of the study.

Auteurs

Rozemarije A Holewijn (RA)

Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Thomas J C Zoon (TJC)

Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands t.j.zoon@amsterdamumc.nl.

Dagmar Verbaan (D)

Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Isidoor O Bergfeld (IO)

Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Esmée Verwijk (E)

Amsterdam Neuroscience, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Gert J Geurtsen (GJ)

Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Geeske van Rooijen (G)

Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Pepijn van den Munckhof (P)

Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Maarten Bot (M)

Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Damiaan A J P Denys (DAJP)

Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Amsterdam Neuroscience, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Rob M A De Bie (RMA)

Department of Neurology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

P Rick Schuurman (PR)

Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Classifications MeSH