Differential Cognitive Effects of Unilateral Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease.

OBJECTIVE: The aim of this study was to investigate the cognitive effects of unilateral directional versus ring subthalamic nucleus deep brain stimulation (STN DBS) in patients with advanced Parkinson's disease. METHODS: We examined 31 participants who underwent unilateral STN DBS (left n = 17; right n = 14) as part of an National Institutes of Health (NIH)-sponsored randomized, double-blind, crossover study contrasting directional versus ring stimulation. All participants received unilateral DBS implants in the hemisphere more severely affected by motor parkinsonism. Measures of cognition included verbal fluency, auditory-verbal memory, and response inhibition. We used mixed linear models to contrast the effects of directional versus ring stimulation and implant hemisphere on longitudinal cognitive function. RESULTS: Crossover analyses showed no evidence for group-level changes in cognitive performance related to directional versus ring stimulation. Implant hemisphere, however, impacted cognition in several ways. Left STN participants had lower baseline verbal fluency than patients with right implants (t [20.66 = -2.50, p = 0.02]). Verbal fluency declined after left (p = 0.013) but increased after right STN DBS (p < 0.001), and response inhibition was faster following right STN DBS (p = 0.031). Regardless of hemisphere, delayed recall declined modestly over time versus baseline (p = 0.001), and immediate recall was unchanged. INTERPRETATION: Directional versus ring STN DBS did not differentially affect cognition. Similar to prior bilateral DBS studies, unilateral left stimulation worsened verbal fluency performance. In contrast, unilateral right STN surgery increased performance on verbal fluency and response inhibition tasks. Our findings raise the hypothesis that unilateral right STN DBS in selected patients with predominant right brain motor parkinsonism could mitigate declines in verbal fluency associated with the bilateral intervention. ANN NEUROL 2024;95:1205-1219.

Symposium: Better teaching through science: incorporating the scholarship of teaching & learning.

The Scholarship of Teaching and Learning, also referred to as SOTL, provides a framework for instructors to evaluate student learning and use evidence to determine pedagogical changes in the classroom. Engagement in SOTL challenges scholars to ask questions about their teaching practices and share with a larger community of practice. Examples of this include manuscript submissions to peer-reviewed journals, presenting abstracts at conferences, and other outlets that allow scholars to disseminate their findings. SOTL practices can be applied within an individual classroom or across a curriculum. Additionally, the promotion and tenure process at many institutions of higher education are highly recommending that faculty demonstrate impact on student learning. This symposium, presented at the 2022 Poultry Science Association Annual Meeting, highlighted best practices in SOTL, implementation of SOTL programming, and discussed using SOTL as a tool to evaluate teaching effectiveness. Poultry and animal science educators shared their experiences with implementing SOTL in their classroom and the benefits to students. From this symposium, we can conclude that there are multiple ways to document teaching excellence and conduct SOTL projects. This is of interest to educators implementing scholarly teaching in their classrooms.