Different outcomes of phonemic verbal fluency in Parkinson’s disease patients with subthalamic nucleus deep brain stimulation

Aline Juliane Romann; Bárbara Costa Beber; Maira Rozenfeld Olchik; Carlos R M. Rieder

doi:10.1590/0004-282X20170024

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(04): 216-220
DOI: 10.1590/0004-282X20170024

ARTICLE

Different outcomes of phonemic verbal fluency in Parkinson’s disease patients with subthalamic nucleus deep brain stimulation

Diferentes desfechos na tarefa de fluência verbal fonêmica em pacientes com doença de Parkinson submetidos à estimulação cerebral profunda

Aline Juliane Romann

¹Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Medicina: Ciências Médicas, Porto Alegre RS, Brasil;

,

Bárbara Costa Beber

¹Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Medicina: Ciências Médicas, Porto Alegre RS, Brasil;

²Faculdade Nossa Senhora de Fátima, Faculdade de Fonoaudiologia, Caxias do Sul RS, Brasil;

,

Maira Rozenfeld Olchik

¹Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Medicina: Ciências Médicas, Porto Alegre RS, Brasil;

³Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Porto Alegre RS, Brasil;

,

Carlos R M. Rieder

¹Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Medicina: Ciências Médicas, Porto Alegre RS, Brasil;

⁴Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brasil;

⁵Universidade Federal Ciências da Saúde, Porto Alegre RS, Brasil.

› Author Affiliations

Abstract

ABSTRACT

Subthalamic nucleus deep brain stimulation (STN-DBS) is a surgical technique to treat motor symptoms in patients with Parkinson’s disease (PD). Studies have shown that STN-DBS may cause a decline in verbal fluency performance. We aimed to verify the effects of STN-DBS on the performance of phonemic verbal fluency in Brazilian PD patients. Sixteen participants were evaluated on the Unified Parkinson’s Disease Rating Scale - Part III and for phonemic fluency (“FAS” version) in the conditions of on- and off-stimulation. We identified two different patterns of phonemic verbal fluency outcomes. The results indicate that there may be no expected pattern of effect of bilateral STN-DBS in the phonemic fluency, and patients may present with different outcomes for some reason not well understood.

RESUMO

A estimulação cerebral profunda do núcleo subtalâmico (ECP-NST) é uma técnica cirúrgica para tratar sintomas motores na doença de Parkinson (DP). Estudos têm mostrado que ECP-NST pode causar um declínio no desempenho de fluência verbal. O objetivo do estudo foi verificar os efeitos da ECP-NST sobre o desempenho da fluência verbal fonêmica em indivíduos brasileiros com DP. Dezesseis participantes foram avaliados quanto ao desempenho motor (UPDRS-III) e à fluência verbal fonêmica (versão “FAS”) nas condições de estimulação ligada e desligada. Identificamos dois padrões diferentes de resultados de fluência verbal fonêmica. Os resultados indicam que pode não haver um padrão esperado de efeito de ECP-NST bilateral na fluência fonêmica, e os pacientes podem apresentar desfechos diferentes de acordo com alguma razão não bem compreendida.

Parkinson disease - deep brain stimulation - language - cognition

doença de Parkinson - estimulação encefálica profunda - linguagem - cognição

Full Text

References

References
1 Fox SH, Katzenschlager R, Lim SY, Ravina B, Seppi K, Coelho M et al. The Movement Disorder Society Evidence-Based Medicine Review Update: treatments for the motor symptoms of Parkinson’s disease. Mov Disord. 2011;26(Suppl 3):S2-41 https://doi.org/10.1002/mds.23829
2 Alberts JL, Voelcker-Rehage C, Hallahan K, Vitek M, Bamzai R, Vitek JL. Bilateral subthalamic stimulation impairs cognitive-motor performance in Parkinson’s disease patients. Brain. 2008;131(12):3348-60. https://doi.org/10.1093/brain/awn238
3 Greenhouse I, Gould S, Houser M, Hicks G, Gross J, Aron AR. Stimulation at dorsal and ventral electrode contacts targeted at the subthalamic nucleus has different effects on motor and emotion functions in Parkinson’s disease. Neuropsychologia. 2011;49(3):528-34. https://doi.org/10.1016/j.neuropsychologia.2010.12.030
4 Castelli L, Perozzo P, Zibetti M, Crivelli B, Morabito U, Lanotte M et al. Chronic deep brain stimulation of the subthalamic nucleus for Parkinson’s disease: effects on cognition, mood, anxiety and personality traits. Eur Neurol. 2006;55(3):136-44. https://doi.org/10.1159/000093213
5 Castelli L, Lanotte M, Zibetti M, Caglio M, Rizzi L, Ducati A et al. Apathy and verbal fluency in STN-stimulated PD patients: an observational follow-up study. J Neurol. 2007;254(9):1238-43. https://doi.org/10.1007/s00415-006-0510-7
6 Cilia R, Siri C, Marotta G, De Gaspari D, Landi A, Mariani CB et al. Brain networks underlining verbal fluency decline during STN-DBS in Parkinson’s disease: an ECD-SPECT study. Parkinsonism Relat Disord. 2007;13(5):290-4. https://doi.org/10.1016/j.parkreldis.2006.11.011
7 Contarino MF, Daniele A, Sibilia AH, Romito LM, Bentivoglio AR, Gainotti G et al. Cognitive outcome 5 years after bilateral chronic stimulation of subthalamic nucleus in patients with Parkinson1s disease. J Neurol Neurosurg Psychiatry. 2007;78(3):248-52. https://doi.org/10.1136/jnnp.2005.086660
8 De Gaspari D, Siri C, Di Gioia M, Antonini A, Isella V, Pizzolato A et al. Clinical correlates and cognitive underpinnings of verbal fluency impairment after chronic subthalamic stimulation in Parkinson’s disease. Parkinsonism Relat Disord. 2006;12(5):289-95. https://doi.org/10.1016/j.parkreldis.2006.01.001
9 Lefaucheur R, Derrey S, Martinaud O, Wallon D, Chastan N, Gérardin E et al. Early verbal fluency decline after STN implantation: is it a cognitive microlesion effect? J Neurol Sci. 2012;321(1-2):96-9. https://doi.org/10.1016/j.jns.2012.07.033
10 Sáez-Zea C, Escamilla-Sevilla F, Katati MJ, Mínguez-Castellanos A. Cognitive effects of subthalamic nucleus stimulation in Parkinson’s disease: a controlled study. Eur Neurol. 2012;68(6):361-6. https://doi.org/10.1159/000341380a
11 Aono M, Iga J, Ueno S, Agawa M, Tsuda T, Ohmori T. Neuropsychological and psychiatric assessments following bilateral deep brain stimulation of the subthalamic nucleus in Japanese patients with Parkinson’s disease. J Clin Neurosci. 2014;21(9):1595-8. https://doi.org/10.1016/j.jocn.2013.12.020
12 Witt K, Pulkowski U, Herzog J, Lorenz D, Hamel W, Deuschl G et al. Deep brain stimulation of the subthalamic nucleus improves cognitive flexibility but impairs response inhibition in Parkinson disease. Arch Neurol. 2004;61(5):697-700. https://doi.org/10.1001/archneur.61.5.697
13 Ehlen F, Krugel LK, Vonberg I, Schoenecker T, Kühn AA, Klostermann F. Intact lexicon running slowly: prolonged response latencies in patients with subthalamic DBS and verbal fluency deficits. PLoS One. 2013;8(11):e79247 https://doi.org/10.1371/journal.pone.0079247
14 Tremblay C, Macoir J, Langlois M, Cantin L, Prud’homme M, Monetta L. The effects of subthalamic deep brain stimulation on metaphor comprehension and language abilities in Parkinson’s disease. Brain Lang. 2015;141:103-9. https://doi.org/10.1016/j.bandl.2014.12.004
15 Strauss E, Sherman E, Spreen O. Executive Functions. A Compendium of neuropsychological tests: administration, norms, and commentary. 3rd ed. Oxford: Oxford University Press; 2006. p. 499-525.
16 Pekkala, S. Verbal fluency tasks and the neuropsychology of language. In: Faust M, ed. The Handbook of the neuropsychology of language. Oxford: Wiley-Blackwell; 2012. p. 619-34.
17 Schwartz S, Baldo J, Graves RE, Brugger P. Pervasive influence of semantics in letter and category fluency: a multidimensional approach. Brain Lang. 2003;87(3):400-11. https://doi.org/10.1016/S0093-934X(03)00141-X
18 Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH. [Suggestions for utilization of the mini-mental state examination in Brazil]. Arq Neuropsiquiatr. 2003;61(3B):777-81. Portuguese. https://doi.org/10.1590/S0004-282X2003000500014
19 Sarmento ALR. Apresentação e aplicabilidade da versão brasileira da MoCA (Montreal cognitive assessment) para rastreio de comprometimento cognitivo leve (MD). São Paulo: Escola Paulista de Medicina da Universidade Federal de São Paulo; 2009.
20 Machado TH, Fichman HC, Santos EL, Carvalho VA, Fialho PP, Koenig AM et al. Normative data for healthy elderly on the phonemic verbal fluency task – FAS. Dement Neuropsychol. 2009;3(1) 55-60. https://doi.org/10.1590/S1980-57642009DN30100011
21 Moldovan AS, Groiss SJ, Elben S, Südmeyer M, Schnitzler A, Wojtecki L. The treatment of Parkinson’s disease with deep brain stimulation: current issues. Neural Regen Res. 2015;10(7):1018-22. https://doi.org/10.4103/1673-5374.160094
22 Wyman-Chick KA. Verbal fluency in Parkinson’s patients with and without bilateral deep brain stimulation of the subthalamic nucleus: a meta-analysis. J Int Neuropsychol Soc. 2016;22(4):478-85. https://doi.org/10.1017/S1355617716000035
23 Ehlen F, Schoenecker T, Kühn AA, Klostermann F. Differential effects of deep brain stimulation on verbal fluency. Brain Lang. 2014;134:23-33. https://doi.org/10.1016/j.bandl.2014.04.002
24 Mikos A, Bowers D, Noecker AM, McIntyre CC, Won M, Chaturvedi A et al. Patient-specific analysis of the relationship between the volume of tissue activated during DBS and verbal fluency. Neuroimage. 2011;54 Suppl 1:S238-46. https://doi.org/10.1016/j.neuroimage.2010.03.068