Verbal Fluency in Essential Tremor Patients: The Effects of Deep Brain Stimulation

Brain Stimulation

Michelle Auth¹  K. Amande M. Pauls²  Mohammad Maarouf³  Matthias Runge³  David J. Pedrosa³  Gereon R. Fink⁴  Lars Timmermann⁴ 

[1] Corresponding author. Department of Neurology, University Hospital Cologne, Joseph-Stelzmann-Str. 9, 50924 Köln, Germany. Tel.: [phone];fax: [phone].;Department of Neurology, University Hospital Cologne, Cologne, Germany;Department of Stereotaxy and Functional Neurosurgery, University Hospital Cologne, Cologne, Germany;

关键词: Cognitive impairment;    Deep brain stimulation;    Thalamus;    Verbal fluency;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objective: To assess the effects of different frequencies of thalamic Deep-Brain-Stimulation (DBS) on cognitive performance of patients suffering from Essential Tremor (ET). Methods: In 17 ET-patients with thalamic-DBS, Tremor-Rating-Scale (TRS), standardized phonemic and semantic verbal fluency (VF), Stroop-Color-Word-Test and Digit-span-test were investigated in three randomized stimulation-settings: i) high-frequency stimulation (HFS), ii) low-frequency stimulation (LFS) and iii) OFF-stimulation (DBS-OFF). Paired-samples t-test for TRS and one-way repeated measures analysis of variance for cognitive performance were calculated. Results: Tremor was reduced during HFS (MeanTRS-HFS = 12.9 ± 9.6) compared to DBS-OFF (MeanTRS-OFF = 44.4 ± 19.8, P < .001) and to LFS (MeanTRS-10Hz = 50.0 ± 24.2; P < .001). While performance of Stroop-task and digit-span remained unaffected by stimulation-settings (P > .05), phonemic and semantic VF differed significantly between the three conditions (FPvf = 5.28, FSvf = 3.41, both P < .05). Post-hoc comparisons revealed significant differences for both phonemic and semantic VF between LFS (MeanPvf-10Hz = 54.6 ± 9.2, MeanSvf-10Hz = 56.4 ± 7.9) and HFS (MeanPvf-ON = 48.3 ± 11.4, MeanSvf-ON = 51.1 ± 11.0, both P < .05), while DBS-OFF (MeanPvf-OFF = 51.2 ± 9.3, MeanSvf-OFF = 53.6 ± 12.9) and HFS and DBS-OFF and LFS did not differ significantly (P > .05). Conclusions: HFS compared to LFS or DBS-OFF significantly reduced tremor but simultaneously worsened VF while working memory and cognitive inhibition remained unaffected. In contrast, LFS enhanced VF but did not ameliorate tremor. The data emphasize the relevance of thalamocortical loops for verbal fluency but also suggest that more sophisticated DBS-regimes in ET may improve both motor and cognitive performance.

【 授权许可】

Unknown