Somma, Teresa (2021) Neuropsychological balance in Parkinson's Patients after Deep Brain Stimulation: total electrical energy delivered or led positioning? [Tesi di dottorato]


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Item Type: Tesi di dottorato
Resource language: English
Title: Neuropsychological balance in Parkinson's Patients after Deep Brain Stimulation: total electrical energy delivered or led positioning?
Date: 10 December 2021
Number of Pages: 33
Institution: Università degli Studi di Napoli Federico II
Department: Neuroscienze e Scienze Riproduttive ed Odontostomatologiche
Dottorato: Neuroscienze
Ciclo di dottorato: 34
Coordinatore del Corso di dottorato:
Cavallo, Luigi MariaUNSPECIFIED
Date: 10 December 2021
Number of Pages: 33
Keywords: Parkinson, DBS, Neuropsychological balance;
Settori scientifico-disciplinari del MIUR: Area 06 - Scienze mediche > MED/25 - Pschiatria
Area 06 - Scienze mediche > MED/26 - Neurologia
Area 06 - Scienze mediche > MED/27 - Neurochirurgia
Date Deposited: 17 Dec 2021 08:24
Last Modified: 28 Feb 2024 11:38

Collection description

Abstract Introduction Parkinson's Disease (PD) is characterized by some cardinal motor signs: 4-6 HZ resting tremor, rigidity, and bradykinesia. Furthermore, most patients may experience neuropsychiatric disturbances throughout their disease, including depression, anxiety, sleep disturbances, psychosis, and behavioral and cognitive changes. The Deep Brain Stimulation has so far proved to be a successful neurosurgical procedure in controlling the motor symptoms associated with PD. However, since 2013, some authors have highlighted a possible correlation between the occurrence of mood disorders such as apathy, depression, and suicidal ideation, and deep brain stimulation surgery. Therefore, to date, several prospective and retrospective studies investigated this phenomenon showing conflicting results, mainly due to differences in population characteristics and study designs. Our study appraised the neuropsychological balance after one-year DBS. Methods From 2011 to 2020, the Neurosurgery Division at Federico II University of Naples performed 53 procedures. Of these patients, fourteen (26%), seven females, and seven males underwent a comprehensive neuropsychological examination at baseline and one year following STN-DBS. The SuretuneTM Medtronic® software ensured a detailed evaluation of the lead position, whereas total electrical energy delivered was estimated using the Koss formula. 4 Results There was no difference in the baseline characteristics. The leads were positioned within the dorsolateral area of the NST for all patients. Evaluation at 12 months in the 14 patients showed a significative clinical improvement in the post-operative UPDRS (p-value = 0,004). The Student's t-test performed between preoperative and postoperative data turned out statistically significant for two psychological tests: HAM-A (p-value 0,0410) and BIS-11(p- value= 0,0483); no significant differences were found in the remaining tests administrated. TEED was not correlated to behavior modifications. Conclusions A tailored and multidisciplinary patient evaluation, alongside a correct target selection, and maximal accuracy, guarantees the best efficacy and safety, without permanent alterations in the neuropsychological asset, following the Deep Brain Stimulation Surgery.


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