Cognition and mood in Parkinson’s disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial.
Okun MS, Fernandez HH, Wu SS, Kirsch-Darrow L, Bowers D, Bova F, Suelter M, Jacobson CE 4th, Wang X, Gordon CW Jr, Zeilman P, Romrell J, Martin P, Ward H, Rodriguez RL, Foote KD. Cognition and mood in Parkinson’s disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial. , March 13, 2009
The purpose of this article was to compare the effects of DBS-STN vs. DBS-GPi, in regard to mood and cognition. The authors looked at various settings and stimulation parameters of both devices with patients off medication so they could evaluate the stimulators alone. Patients were also given various cognitive and mood measures prior to surgery and then again 7 months after surgery. It is notable that 7 patients did not continue the study after surgery due to adverse events (could not tolerate protocol, hemorrhage, and pneumonia related death [one]). We would refer the reader to the supplementary tables in the article for more specific information about adverse events for those that remained in the study, although most were mild and did not last long. However, the authors noted that the STN group had more adverse events than the GPi group.
Generally, this article showed that there were few differences in mood and cognition between STN and GPi when both groups were at their optimal settings. They concluded that the verbal fluency finding (naming as many words that start with a specified letter as fast as one can) likely is a result of the surgery as the effect was still there when the stimulator was not on for the DBS-STN group. The authors also discussed that their findings suggest that the target of DBS may best be done based on individual patient characteristics (e.g. cognitive issue, behavioral concern, medication reduction, etc.). It also showed different stimulator settings and areas that should be avoided in individuals with specific complaints (e.g. less energetic, less happy, etc.), which is very beneficial information for those doing the placement as well as the programming of the devices in improving the care and quality of life of individuals with DBS STN or GPi.