Title

Pulse width is associated with cognitive decline after thalamic stimulation for essential tremor

Document Type

Article

Abstract

The present study sought to identify predictors of cognitive decline after thalamic deep brain stimulation (DBS) for essential tremor (ET). Twenty-seven patients (55%) with ET demonstrated mild cognitive decrements relative to pre-surgical baseline (ET-D), whereas 22 patients (45%) were classified as neuropsychologically stable (ET-S). The ET-D and ET-S groups were comparable in terms of baseline demographic, disease, and neuropsychological characteristics, as well as post-surgical motor outcomes. However, the ET-D group had significantly higher pulse width (PW) stimulator settings, and a greater proportion of ET-D than ET-S patients underwent left in comparison to right thalamic stimulation. A subsequent step-wise discriminant function analysis revealed that disease onset after age 37 years and higher PW settings (>or=120 micros) were the strongest predictors of post-surgical cognitive decline in this sample. Findings indicate that although relatively higher PW settings might afford optimal tremor control in some patients, the corresponding risk of mild, probably often subclinical, cognitive morbidity must be weighed accordingly.

Medical Subject Headings

Aged; Cognition Disorders (diagnosis, etiology); Electric Stimulation Therapy (adverse effects, methods); Essential Tremor (physiopathology, therapy); Female; Humans; Male; Neuropsychological Tests; Thalamus (physiopathology)

Publication Date

6-1-2003

Publication Title

Parkinsonism & related disorders

ISSN

1353-8020

Volume

9

Issue

5

First Page

295

Last Page

300

PubMed ID

12781597

Digital Object Identifier (DOI)

10.1016/s1353-8020(03)00014-2

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