Reliable cognitive change following unilateral deep brain stimulation in essential tremor

Appl Neuropsychol Adult. 2024 Jul-Aug;31(4):601-605. doi: 10.1080/23279095.2022.2048303. Epub 2022 Mar 15.

Abstract

Objective: This retrospective analysis assessed regression-based reliable change (RC) of cognition in a sample of essential tremor (ET) patients who underwent unilateral deep brain stimulation of the ventral intermediate nucleus of the thalamus (VIM-DBS).Method: Thirty patients (mean age at pre-evaluation = 70.4 ± 6.3 years) underwent neuropsychological evaluation pre- and post-unilateral VIM-DBS placement (mean time between pre and post-evaluation = 13.1 ± 4.0 months). Paired samples t-tests and RC analyses were employed.Results: No significant within-group differences were observed when cognitive scores were compared between evaluations. The vast majority of patients demonstrated stability across pre-and post-surgical evaluations (i.e. 29 out of 30); however, those with high-risk co-morbid medical conditions may be vulnerable to post-surgical cognitive decline as indicated by RC measures.Conclusions: The use of regression-based RC indices to assess individual cognitive changes between pre and post-surgical evaluations control for systematic and measurement errors that can occur over repeated evaluations, and may be able to identify cognitive changes that evade detection in traditional within-group comparisons.

Keywords: Reliable change index; deep brain stimulation; neuropsychological assessment.

MeSH terms

  • Aged
  • Cognition / physiology
  • Cognitive Dysfunction* / etiology
  • Cognitive Dysfunction* / physiopathology
  • Cognitive Dysfunction* / therapy
  • Deep Brain Stimulation*
  • Essential Tremor* / physiopathology
  • Essential Tremor* / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Retrospective Studies
  • Ventral Thalamic Nuclei / physiology