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Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: persistent improvement in mobility but increased dependency: a case study
Hariz MI, Johansson F, Shamsgovara P, Johansson E, Hariz GM, Fagerlund M.. Movement disorders : official journal of the Movement Disorder Society, 2000-01-01
Topic: Brain proteins, microglia and lab models
We report a patient with advanced Parkinson's disease, including severe and frequent off periods with freezing of gait, moderate dysphonia, and some cognitive impairment, who underwent bilateral subthalamic nucleus (STN) stimulation. The patient was followed for 1 year after surgery, showing persistent good mobility without off periods and without freezing, which reverted completely when stopping the stimulation. There was deterioration of cognition as well as increased aphonia and drooling, all of which remained when the stimulation was turned off. The striking improvement in motor symptoms following STN stimulation was not paralleled by improvement in disability, probably as a result of a cognitive decline, suggesting a diagnosis of Parkinson's disease with dementia. We conclude that chronic STN stimulation is efficient in alleviating akinetic motor symptoms including gait freezing; this surgery should be offered before patients start to exhibit speech or cognitive disturbances.
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APA 7th
Hariz, M. I., Johansson, F., Shamsgovara, P., Johansson, E., Hariz, G. M., & Fagerlund, M. (2000). Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: persistent improvement in mobility but increased dependency: a case study. Movement disorders : official journal of the Movement Disorder Society. https://doi.org/10.1002/1531-8257(200001)15:1<136::aid-mds1021>3.0.co;2-5
Vancouver
Hariz MI, Johansson F, Shamsgovara P, Johansson E, Hariz GM, Fagerlund M. Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: persistent improvement in mobility but increased dependency: a case study. Movement disorders : official journal of the Movement Disorder Society. 2000. doi:10.1002/1531-8257(200001)15:1<136::aid-mds1021>3.0.co;2-5. PMID: 10634253.
BibTeX
@article{hariz2000-10634253,
author = {Hariz, M. I. and Johansson, F. and Shamsgovara, P. and Johansson, E. and Hariz, G. M. and Fagerlund, M.},
title = {{Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: persistent improvement in mobility but increased dependency: a case study}},
journal = {Movement disorders : official journal of the Movement Disorder Society},
year = {2000},
doi = {10.1002/1531-8257(200001)15:1<136::aid-mds1021>3.0.co;2-5},
pmid = {10634253},
url = {https://doi.org/10.1002/1531-8257(200001)15:1<136::aid-mds1021>3.0.co;2-5}
}
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Key findings
- The striking improvement in motor symptoms following STN stimulation was not paralleled by improvement in disability, probably as a result of a cognitive decline, suggesting a diagnosis of Parkinson's disease with dementia.
- We conclude that chronic STN stimulation is efficient in alleviating akinetic motor symptoms including gait freezing; this surgery should be offered before patients start to exhibit speech or cognitive disturbances.
Why it matters
In one patient with Parkinson's disease, bilateral subthalamic nucleus stimulation improved mobility but was accompanied by cognitive decline and increased dependency. This case study is about Parkinson's disease surgery and does not address treating, curing, or preventing Alzheimer's disease.
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Study details
- Evidence strengthLow
How this study scored 40/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Movement disorders : official journal of the Movement Disorder Society) |
| Journal's citation record | 3 / 4 | Movement Disorders: journal h-index 281 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2000 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 105 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.8 citations a year over 28 year(s) since 2000 |
| Impact for its field and year | 3 / 6 | Cited 4.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Markku K. J. Fagerlund: h-index 25 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | University Hospital of Umeå: institution h-index 322 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 10634253) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 40 / 100 | — |
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