Systematic review of neuropsychological instruments used in subthalamic nucleus deep brain stimulation in Parkinson´s disease patients

Barbosa, Eduarda Naidel Barboza e; Charchat-Fichman, Helenice

doi:10.1590/1980-57642018dn13-020004

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Dementia & Neuropsychologia

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Original Article • Dement. neuropsychol. 13 (2) • Apr-Jun 2019 • https://doi.org/10.1590/1980-57642018dn13-020004 copy

Systematic review of neuropsychological instruments used in subthalamic nucleus deep brain stimulation in Parkinson´s disease patients

Revisão Sistemática de Instrumentos Neuropsicológicos usados em Pacientes com Doença de Parkinson e Estimulação Cerebral Profunda no Núcleo Subtalâmico

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT.

In addition to drug treatment, surgical intervention represents an alternative to PD patients with motor deficits. The most common intervention is subthalamic nucleus deep brain stimulation (STN-DBS). It is extremely important to perform a neuropsychological assessment in patients with STN-DBS, not only to identify losses related to the disease, but also to compare influence on cognition both pre and postoperatively.

Objective:

the objective of this systematic review was to investigate the instruments frequently used in studies related to STN-DBS in PD patients.

Methods:

articles were retrieved from Medline/Pubmed databases published in the 2007-2017 period using PRISMA criteria.

Results:

after analyzing 27 articles, the absence of a specific evaluation protocol for PD with STN-DBS was evident.

Conclusion:

non-motor symptoms are not given due importance in neuropsychological assessments. It is crucial to acknowledge that these symptoms have a major impact on the quality of life of patients. Greater engagement in assessing these aspects is required, in order to bridge the gaps in research.

Key words:
Parkinson’s disease; deep brain stimulation; neuropsychological instruments; neuropsychological assessment

	Authors and name	Year	Instruments used
1	Cilia et ai. Brain networks underlining verbal fluency decline during STN-DBS in Parkinson’s disease: An ECD-SPECT study.	2007	Mini-Mental State Exam (MMSE), Phonemic and Semantic Verbal Fluency Tasks, Wisconsin Card Sorting Test (WCST), Raven's Progressive Matrices (RPM)
2	Klempirova et al. Deep brain stimulation of the subthalamic nucleus and cognitive functions in Parkinson’s disease.	2007	Mattis Dementia Rating Scale (MDRS), Wechsler Memory Scale-Ill (WMS), Stroop Test, VFT
3	Castelli et al. Apathy and verbal fluency in STN-stimulated PD patients.	2007	RPM, Bi-Syllabic Words Repetition test (BWR), Corsi's Block Tapping test (CBTT), WMS, Trail Making Test (TMT), Nelson Modified Card Sorting test (MCST), VTF, Beck Depression Inventory (BDI), Apathy Evaluation Scale (AES)
4	Heo et al. The effects of bilateral Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) on cognition in Parkinson disease.	2008	TMT, Korean Boston Naming test (K-BNT), Rey-Kim Memory Battery, Grooved pegboard test, WCST, Stroop test, VFT, Korean Mini-Mental Status Examination (K-MMSE), BDI
5	Witt et al. Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s disease: a randomised, multicentre study.	2008	UPDRS-I MDRS, German Rey's Auditory Verbal Learning Test (G-RAVLT), Wechsler Adult Intelligence Scale (WAIS), Benton Visual Retention Test, Stroop test, VFT, BDI, Montgomery- Asberg Depression Rating Scale (MADRS), Beck Anxiety Inventory (BAI), Parkinson's Disease Questionnaire (PDQ-39)
6	Alberts et al. Bilateral subthalamic stimulation impairs cognitive-motor performance in Parkinson’s disease patients.	2008	N-backtask, dual task
7	Lueken et al. Impaired performance on the Wisconsin Card Sorting Test under left- when compared to right-sided deep brain stimulation of the subthalamic nucleus in patients with Parkinson’s disease.	2008	MMSE, WCST, German Hospital Anxiety and Depression Scale (HADS-D), German Apathy Evaluation Scale (AES) *
8	Zangaglia et al. Deep brain stimulation and cognitive functions in Parkinson’s disease: A three-year controlled study	2009	MMSE, long memory task, verbal span, digit span, CBTT, WCST, RPM, FVT
9	York et al. Relationship between neuropsychological outcome and DBS surgical trajectory and electrode location	2009	MMSE, RAVLT, VFT, MDRS, BDI, State-Trait Anxiety Inventory (STAI)
10	Williams et al. Deep brain stimulation plus best medical therapy versus best medical therapy alone for advanced Parkinson’s disease.	2009	UPDRS-I, PDQ-39, MDRS, Delis-Kaplan executive function system (D-KEFS), Wechsler Abbreviated Scale Intelligence (WASI)
11	Daniels et al. Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson’s disease	2010	MDRS, RAVLT, WAIS, BVRT, Stroop test, VFT
12	Castelli et al. Neuropsychological changes 1-year after subthalamic DBS in PD patients: A prospective controlled study	2010	RPM, Bi-Syllabix Words Repetition Test, Corsi's Block Tapping test, Paired Associate Learning, Trail Making Test, MCST, VFT
13	Fasano et al. Motor and cognitive outcome in patients with Parkinson’s disease 8 years after subthalamic implants	2010	MMSE, Corsi's Block Tapping Test, digit span forward, digit span backward, RAVLT, RPM, MWCST, VFT, Zung's depression Scale, Zung's Anxiety Scale
14	Van Wouwe et al. Deep Brain Stimulation of the Subthalamic Nucleus Improves Reward- Based Decision-Learning in Parkinson’s Disease	2011	Flaruno and Kawato Task, MMSE
15	Israeli-Korn et al. Subthalamic Nucleus Deep Brain Stimulation Does Not Improve Visuo- Motor Impairment in Parkinsons Disease	2013	MMSE, BDI, VFT, Frontal Assessment Battery (FAB), Visual Analog Mood Scale, Digit Span Forward and Digit Span Backward, Finger Tapping Test, Visual-motor Coordination Task
16	Kim et al. Initial cognitive dip after subthalamic deep brain stimulation in Parkinson disease	2013	MMSE, TMT, K-BNT, Rey-Kim Memory Battery, Stroop Test, VFT, BDI
17	Yagiiez et al. Cognitive predictors of cognitive change following bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease	2014	WAIS-III, Recognition Memory Test, Birt Memory and Information Processing Battery, Graded Naming Test, Visual Object and Space Perception Battery, Hayling Sentence Completion Test, Brixton Spatial Anticipation Test, VFT
18	Asahi et al. Impact of bilateral subthalamic stimulation on motor/cognitive functions in Parkinson’s disease	2014	MMSE, Japanese Adult Reading Test (JART), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), WAIS-Revised
19	Rizzone et al. Long-term outcome of subthalamic nucleus DBS in Parkinson’s disease: From the advanced phase towards the late stage of the disease?	2014	UPDRS-I, MMSE, RPM, Digit Span Forward, Corsi's Block Test, MWCST, VFT, RAVLT, TMT, Paired Associated Learning, Attentive Matrices, Zung's Depression Scale, Zung's Anxiety Scale, BDI, State-Trait Anxiety Inventory (STAI)
20	Houvenaghel et al. Reduced Verbal Fluency following Subthalamic Deep Brain Stimulation: A Frontal-Related Cognitive Deficit?	2015	MDRS, VFT, Stroop Test, TMT, MCST, MADRS, Apathy Evaluation Scale (AES)
21	Markser et al. Deep brain stimulation and cognitive decline in Parkinson’s disease: The predictive value of electroencephalography	2015	MMSE, MDRS, Dem-Tech
22	Pham et al. Self-Reported Executive Functioning in Everyday Life in Parkinson’s Disease after Three Months of Subthalamic Deep Brain Stimulation	2015	MDRS, Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), Symptom Checklist 90 - Revised (SCL-90-R), AES
23	Tang et al. Evidence of improved immediate verbal memory and diminished category fluency following STN-DBS in Chinese-Cantonese patients with idiopathic Parkinson’s disease	2015	Montreal Cognitive Assessment Hong Kong version (HK-MoCA), Chinese Auditory Verbal Learning Test (CAVLT), BVRT, Chinese modified version of BNT, Hooper Visual Organization Test (HVOT), Stroop Test Chinese Victoria version, VFT (semantic), BDI-II, BAI
24	Tremblay et al. The effects of subthalamic deep brain stimulation on metaphor comprehension and language abilities in Parkinson’s disease	2015	MoCA, Metaphor Comprehension Task, VFT (semantic), Alternation VFT, Lexical Decision Test, Word Association Test, BDI version IA
25	Krishnan et al. The decade after subthalamic stimulation in advanced Parkinson’s disease: A balancing act.	2016	UPDRS-I, MMSE, Addenbrooke's Cognitive Examination, BDI, Parkinson's Disease Quality of Life (PDQL) Questionnaire
26	Vonberg et al. Fabian. Deep Brain Stimulation of the Subthalamic Nucleus Improves Lexical Switching in Parkinson’s Disease Patients	2016	Parkinson Neuropsychometric Dementia Assessment (PANDA), German VFT
27	Ventre-Dominey et al. Distinct effects of dopamine vs STN stimulation therapies in associative learning and retention in Parkinson disease	2016	Conditional Associative Learning (CAL), Visual spatial Working Memory Task, Non-spatial Working Memory Task

N°	Domains Assessed	Instruments	N° of articles
1	Activities of Daily Living	UPDRS-I Non-Motor Experiences	3
2	PD Quality of Life	Parkinson's Disease Questionnaire (PDQ-39)	2
2	PD Quality of Life	Parkinson's Disease Quality of Life (PDQL)	1
3	Global Functioning	Mini-Mental State Exam (MMSE)*	14
		Mattis Dementia Rating Scale (MDRS)	8
		Raven's Progressive Matrices (RPM)	6
		Wechsler Adult Intelligence Scale (WAIS-III)*	4
		Montreal Cognitive Assessment (MoCA)*	2
		Addenbrooke's Cognitive Examination	1
		Japanese Adult Reading Test (JART)	1
		Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)	1
		Dem-Tech	1
		Parkinson Neuropsychometric Dementia Assessment (PANDA)	1
4	Psychiatric Symptoms	Brief Psychiatric Rating Scale (BPRS)	1
		Visual Analogue Mood Scale	1
		Symptom Checklist 90 - Revised (SCL-90-R)	1
5	Executive Functioning	Verbal Fluency Tasks - Semantic*	19
		Verbal Fluency Tasks - Phonemic*	17
		Wisconsin Cards Sorting Test (WCST)*	9
		Stroop Test*	7
		Trail Making Test (TMT)*	6
		Digit Span Forward and Backward	5
		Frontal Assessment Battery (FAB)	1
		Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A)	1
		Hayling Sentence Completion Test	1
		Brixton Spatial Anticipation Test	1
		Haruno and Kawato Task (2006)**	1
		Delis-Kaplan Executive Function System (D-KEFS)	1
		N-back and dual task	1
		Visual Spatial and Non-spatial Working Memory Task	1
6	Memory	Rey's Auditory Verbal Learning Test (RAVLT)*	6
		Corsi's Block Tapping Test (CBTT)	5
		Paired Associate Learning (Wechsler Memory Scale)	4
		Bi-Syllabic Words Repetition test (BWR)	2
		Rey-Kim Memory Battery	2
		Recognition Memory Test	1
		Birt Memory and Information Processing Battery	1
		Long Memory Task and Verbal Span	1
		Conditional Associative Learning (CAL)**	1
7	Language	Boston Naming Test (BNT)*	3
		Graded Naming Test	1
		Metaphor Comprehension Task	1
		Lexical Decision Test	1
		Word Association Test	1
8	Language	Attentive Matrices	1
9	Perception	Incomplete Letters and Object Decision tasks (Visual Object and Space Perception Battery)	1
10	Visuospatial Skills	Benton Visual Retention Test	3
10	Visuospatial Skills	Hooper Visual Organization Test (HVOT)	1
11	Mood	Beck Depression Inventory (BDI)	10
		Apathy Evaluation Scale (AES)*	4
		State-Trait Anxiety Inventory (STAI)	2
		Zung's Anxiety Scale	2
		Beck Anxiety Inventory (BAI)	2
		Zung's Depression Scale	2
		Montgomery-Asberg Depression Rating Scale (MADRS)	2
		Hospital Anxiety and Depression Scale (HADS-D)*	1
		Snaith-Hamilton Pleasure Scale	1
		Bech-Rafaelsen Mania Scale	1
12	Sensory-Motor Coordination	Grooved Pegboard Test	1
		Visual-motor Coordination Task	1
		Finger Tapping Test	1

Instruments
• Parkinson's Disease Questionnaire (PDQ-39)
• Parkinson's Disease Quality of Life (PDQL)
• Mini-Mental State Exam (MMSE)*
• Mattis Dementia Rating Scale (MDRS)
• Raven's Progressive Matrices (RPM)
• Symptom Checklist 90 - Revised (SCL-90-R)
• Verbal Fluency Tasks - Semantic*
• Verbal Fluency Tasks - Phonemic*
• Wisconsin Cards Sorting Test (WCST)*
• Stroop Test*
• Trail Making Test (TMT)*
• Digit Span Forward and Backward
• Rey's Auditory Verbal Learning test (RAVLT)*
• Corsi's Block Tapping test (CBTT)
• Rey-Kim Memory Battery
• Boston Naming Test (BNT)*
• Attentive Matrices
• Incomplete Letters and Object Decision tasks
• (Visual Object and Space Perception Battery)
• Benton Visual Retention Test
• Beck Depression Inventory (BDI)
• Apathy Evaluation Scale (AES)*
• State-Trait Anxiety Inventory (STAI)
• Beck Anxiety Inventory (BAI)
• Grooved Pegboard Test

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[1] Eduarda Naidel Barboza e Barbosa. Rua Marquês de São Vicente, 225 / Gávea - 22451-900 Rio de Janeiro RJ - Brazil. E-mail: psienbb@gmail.com