Neuropsychological Outcome in Subthalamic Nucleus Stimulation Surgeries with Electrodes Passing through the Caudate Nucleus

Cihan Isler*, Angela Albi, Frederic L. W. V. J. Schaper, Yasin Temel, Annelien Duits

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Web of Science)


Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson disease (PD) is associated with postoperative cognitive decline. One of the proposed underlying mechanisms is the surgical procedure with the lead trajectory penetrating the caudate nucleus. Objective: To study whether penetration of the caudate nucleus affects neuropsychological outcome. Methods: Neuropsychological and imaging data of 30 PD patients who underwent bilateral STN DBS were analysed. Lead trajectories were evaluated leading to a group with (n = 10) and a group without penetration of the caudate nucleus (n = 20). The neuropsychological performance of each group was compared to baseline, both at 3 and 12 months postoperatively. Results: Only the Trail-Making Test part B (TMT-B) showed an interaction effect within the groups over time at 3 months postoperatively. At 12 months postoperatively, there was only a main effect of time with a decrease in performance in TMT-B for both groups. Also verbal fluency showed a significant decrease over time for both groups at 3 and 12 months postoperatively. Conclusion: Caudate nucleus penetration affects cognitive flexibility only in the short term after surgery.
Original languageEnglish
Pages (from-to)413-420
JournalStereotactic and Functional Neurosurgery
Issue number6
Publication statusPublished - 2016


  • Deep brain stimulation
  • Caudate nucleus
  • Cognitive decline
  • Neuropsychological outcome
  • Subthalamic nucleus

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