Neuropsychology Review

, Volume 25, Issue 4, pp 439–454 | Cite as

Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson’s Disease: A Meta-Analysis

  • Hannah L. Combs
  • Bradley S. Folley
  • David T. R. Berry
  • Suzanne C. Segerstrom
  • Dong Y. Han
  • Amelia J. Anderson-Mooney
  • Brittany D. Walls
  • Craig van Horne


Parkinson’s disease (PD) is a common, degenerative disorder of the central nervous system. Individuals experience predominantly extrapyramidal symptoms including resting tremor, rigidity, bradykinesia, gait abnormalities, cognitive impairment, depression, and neurobehavioral concerns. Cognitive impairments associated with PD are diverse, including difficulty with attention, processing speed, executive functioning, memory recall, visuospatial functions, word-retrieval, and naming. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus internus (GPi) is FDA approved and has been shown to be effective in reducing motor symptoms of PD. Studies have found that stimulating STN and GPi are equally effective at improving motor symptoms and dyskinesias; however, there has been discrepancy as to whether the cognitive, behavioral, and mood symptoms are affected differently between the two targets. The present study used random-effects meta-analytic models along with a novel p-curve analytic procedure to compare the potential cognitive and emotional impairments associated with STN-DBS in the current literature to those associated with GPi-DBS. Forty-one articles were reviewed with an aggregated sample size of 1622 patients. Following STN-DBS, small declines were found in psychomotor speed, memory, attention, executive functions, and overall cognition; and moderate declines were found in both semantic and phonemic fluency. However, GPi-DBS resulted in fewer neurocognitive declines than STN-DBS (small declines in attention and small-moderate declines in verbal fluency). With regards to its effect on depression symptomatology, both GPi-DBS and STN-DBS resulted in lower levels of depressive symptoms post-surgery. From a neurocognitive standpoint, both GPi-DBS and STN-DBS produce subtle cognitive declines but appears to be relatively well tolerated.


Parkinson’s disease Deep brain stimulation Pallidal Subthalamic Cognition 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Supplementary material

11065_2015_9302_MOESM1_ESM.doc (30 kb)
ESM 1 (DOC 30 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Hannah L. Combs
    • 1
  • Bradley S. Folley
    • 2
    • 3
  • David T. R. Berry
    • 1
  • Suzanne C. Segerstrom
    • 1
  • Dong Y. Han
    • 4
  • Amelia J. Anderson-Mooney
    • 4
  • Brittany D. Walls
    • 1
  • Craig van Horne
    • 3
  1. 1.Department of PsychologyUniversity of KentuckyLexingtonUSA
  2. 2.Norton Neuroscience InstituteLouisvilleUSA
  3. 3.Department of NeurosurgeryUniversity of KentuckyLexingtonUSA
  4. 4.Department of NeurologyUniversity of KentuckyLexingtonUSA

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