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Purpose: This systematic review focuses on the effect of bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) on language function in Parkinson's disease (PD). It fills an important gap in recent reviews by considering other language tasks in addition to verbal fluency. Method: We critically and systematically reviewed the literature on studies that investigated the effect of bilateral STN-DBS on language function in PD. All studies included a matched PD control group who were on best medical treatment, with language testing at similar baseline and follow-up intervals as the DBS PD group. Results: Thirteen identified studies included a form of a verbal fluency task, seven studies included picture naming, and only two studies included more language-oriented tasks. We found that verbal fluency was negatively affected after DBS, whereas picture naming was unaffected. Studies investigating individual change patterns using reliable change indices showed that individual variability is larger for picture naming than for verbal fluency. Conclusions: Verbal fluency is the most frequently investigated aspect of language function. Our analysis showed a pattern of decline in verbal fluency across multiple studies after STN-DBS, whereas picture naming was unaffected. Data on more language-oriented tests in a large DBS sample and best medical treatment control group are sparse. The investigation of language function in PD after DBS requires sensitive language tests (with and without time pressure) and experimental designs as used in the studies reviewed here. Reliable change index statistics are a promising tool for investigating individual differences in performance after DBS.

Purpose: This systematic review focuses on the effect of bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) on language function in Parkinson's disease (PD). It fills an important gap in recent reviews by considering other language tasks in addition to verbal fluency. Method: We critically and systematically reviewed the literature on studies that investigated the effect of bilateral STN-DBS on language function in PD. All studies included a matched PD control group who were on best medical treatment, with language testing at similar baseline and follow-up intervals as the DBS PD group. Results: Thirteen identified studies included a form of a verbal fluency task, seven studies included picture naming, and only two studies included more language-oriented tasks. We found that verbal fluency was negatively affected after DBS, whereas picture naming was unaffected. Studies investigating individual change patterns using reliable change indices showed that individual variability is larger for picture naming than for verbal fluency. Conclusions: Verbal fluency is the most frequently investigated aspect of language function. Our analysis showed a pattern of decline in verbal fluency across multiple studies after STN-DBS, whereas picture naming was unaffected. Data on more language-oriented tests in a large DBS sample and best medical treatment control group are sparse. The investigation of language function in PD after DBS requires sensitive language tests (with and without time pressure) and experimental designs as used in the studies reviewed here. Reliable change index statistics are a promising tool for investigating individual differences in performance after DBS. Supplemental Material: https://doi.org/10.23641/asha. 14794458, Parkinson's disease (PD) is a neurodegenerative disease characterized by motor symptoms (i.e., bradykinesia with rest tremor and/or rigidity; Berg et al., 2018; Hughes et al., 1992). Beside motor symptoms, patients [...]

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is successful in patients with advanced Parkinson's disease (PD) but may worsen cognitive outcome, including facial emotion recognition (FER). Data‐analyses on 59 consecutive PD patients with complete pre‐ and postoperative assessments, using a sensitive FER test, showed no changes in FER 1 year after STN‐DBS surgery, both after group and individual analyses. These findings do however not exclude the impact of FER in and on itself on the outcome after STN‐DBS. [ABSTRACT FROM AUTHOR]

Background: Deep brain stimulation (DBS) is a commonly used treatment for movement disorders with additional indications including epilepsy and neuropsychiatric diseases. Although DBS has proven to be effective and safe, success highly depends on the accuracy of stereotactic targeting and the prevention of surgery related complications, such as haemorrhage, infection and suboptimal lead placement. Our centre employs an image-guided image-verified approach with direct targeting on tailored MRI sequences that allow direct visualisation of the anatomical target followed by routine immediate postoperative stereotactic imaging. We report safety and accuracy data from a large consecutive series of image-guided and image-verified DBS within an intraoperative MRI suite. Methods: The records of all patients who underwent DBS surgery in the period from August 2011 to August 2016 at The National Hospital for Neurology and Neurosurgery, Queen Square, London were reviewed. Data collected included the accuracy of targeting and the need for immediate relocation of DBS leads, as well as the occurrence of surgical complications. Results: A total of 399 patients underwent 725 electrode implantations on a total of 13 targets. All patients were operated under general anaesthesia except when targeting the ventral intermediate nucleus of the thalamus for tremor. It was often possible for two patients to undergo DBS in one day. The indications for surgery were: Parkinson's disease (PD) 208 (52.1%), dystonia 77 (19.3%), tremor 34 (8.5%), Tourette's syndrome 17 (4.3%), PD dementia or Lewy body dementia 12 (3.0%), obsessivecompulsive disorder (OCD) 6 (1.5%), trigeminal autonomic cephalalgia 42 (10.6%), chronic post-stroke pain 2 (0.5%) and progressive supranuclear palsy (PSP) 1 (0.3%).Based on stereotactic accuracy and anatomical location, 21 (2.9%) leads were relocated immediately by 1.5 to 3.0mm. Final placement of all leads was within 2mm of the intended target with a maximum of two brain passes. The overall infection rate was 2.8%. Postoperative imaging revealed a small haemorrhage in 2 patients (0.5%), one asymptomatic subcortical and one peduncular, the latter associated with permanent cognitive, behavioural and gait difficulties. Conclusion: MRI-guided and MRI-verified DBS is a safe and accurate technique. A surgical theatre equipped with an MRI scanner allows immediate verification of targeting accuracy and is time-saving, allowing to implant more than one patient in one day. [ABSTRACT FROM AUTHOR]