Neuropsychological, neuropsychiatric, and quality of life issues in DBS for dystonia

We review the impact of dystonia and its surgical treatment with deep brain stimulation (DBS) on cognitive function, psychiatric morbidity, and health‐related quality of life. The current evidence suggests that globus pallidus internus (GPi) DBS does not cause cognitive decline in primary dystonia....

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Bibliographic Details
Published in:	Movement disorders Vol. 26; no. S1; pp. S63 - S78
Main Authors:	Jahanshahi, Marjan, Czernecki, Virginie, Zurowski, and Mateusz
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-06-2011 Wiley Subscription Services, Inc
Subjects:	cognition Cognition Disorders - etiology Cognition Disorders - therapy DBS Deep Brain Stimulation - adverse effects Deep Brain Stimulation - methods dystonia Dystonia - complications Dystonia - psychology Dystonia - therapy Globus Pallidus - physiology Humans Mental Disorders - etiology Mental Disorders - therapy Movement disorders Neuropsychological Tests psychiatric quality of life Quality of Life - psychology Severity of Illness Index surgery
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Summary:	We review the impact of dystonia and its surgical treatment with deep brain stimulation (DBS) on cognitive function, psychiatric morbidity, and health‐related quality of life. The current evidence suggests that globus pallidus internus (GPi) DBS does not cause cognitive decline in primary dystonia. However, we recommend general preoperative screening of cognition in patients with dystonia to evaluate baseline cognitive status and monitor for possible postoperative changes. Patients with mild to moderate depression appear to do well postoperatively; however, there are scant data about those with severe depression. This is particularly problematic given reports of postoperative suicide. Patients with tardive dystonia seem to do well post‐GPi DBS despite often having a history of depression or even having active severe depression. We make recommendations for screening and basic management strategies of patients identified as having a major psychiatric illness pre‐ or postoperatively. Quality of life in dystonia patients quantified by generic measures such as the SF36 showed improvement in both mental and physical categories following DBS surgery. © 2011 Movement Disorder Society
Bibliography:	ark:/67375/WNG-18Z57V21-T Potential conflicts of interest: Nothing to report. istex:731FBC3271032D7D7773FA7FF8777833F771DAE2 ArticleID:MDS23511 Nothing to report. Potential conflicts of interest ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	0885-3185 1531-8257
DOI:	10.1002/mds.23511