. Cognitive functions in a patient with Parkinson-dementia syndrome undergoing deep brain stimulation. Arch Neurol. 2009 Jun;66(6):781-5. PubMed.

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  1. While the results in this patient, who was treated by a reputable DBS team, are interesting, I would caution the public not to make too much of this one case. First, it is widely known that performing standard STN DBS surgery on PD patients with even early dementia can severely worsen their cognitive condition. One would expect that inserting four DBS electrodes (rather than the standard two) through the frontal lobes will increase that risk further and that such complications will arise if more of these procedures are performed. Second, the NBM is a thin ribbon of tissue and the electrical field created with the stimulation parameters employed extended well beyond this area. Moreover, the authors provided neither microelectrode recording data nor a post-operative MRI to prove that the electrodes were within the NBM. Third, between weeks 25 and 29, as shown in Figure 2, there is a downward trend in all of their cognitive measures. Finally, I would view with great skepticism any claims that stimulation is neuroprotective, especially based on results in one patient. A neuroprotective role for DBS has been proposed in the past but has never been proven.