{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:37:06Z","timestamp":1790937426239,"version":"4.1.0"},"reference-count":37,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Subthalamic nucleus (STN) and globus pallidus internus (GPI) deep brain stimulation (DBS) effectively treat motor symptoms in Parkinson\u2019s disease (PD) but may be associated with cognitive and psychiatric changes in some patients. Evaluation of changes in cognitive and psychiatric symptoms following DBS is complicated by changes in these symptoms that occur as part of the natural disease course. The aim of this study was to evaluate whether electrode position was associated with changes in neurocognitive symptoms in patients who underwent STN and GPI DBS.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A single-institution retrospective cohort study was conducted on patients with PD who underwent DBS from 2008 to 2019. Cognitive and psychiatric outcomes included Beck Depression Inventory II (BDI-II) score, presence of impulsive-compulsive behavior (ICB), Mini-Mental State Examination (MMSE) score, and overall cognitive status grade determined by comprehensive neuropsychology testing (normal, mild impairment, moderate impairment, and dementia). Pre- and postoperative comparisons were performed using a Wilcoxon signed-rank test or paired t-test. Patients with and without cognitive decline were compared using a Mann-Whitney U-test or unpaired t-test. A chi-square test was used for categorical comparisons.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>One hundred thirty patients were included (mean age 62.5 \u00b1 7.9 years). At a mean postoperative follow-up from DBS of 13.0 \u00b1 12.7 (range 6\u201366) months, there was an improvement in ICB (26.3% preoperatively vs 15.0% postoperatively, p = 0.017), but a decline in MMSE score (28.6 \u00b1 1.6 vs 27.6 \u00b1 2.0, p &lt; 0.001) and overall cognitive status (normal: 66.2% vs 39.2%; mild: 12.3% vs 17.7%; moderate: 21.5% vs 33.1%; dementia: 0.0% vs 10.0%; p &lt; 0.001). Patients undergoing STN DBS had a worse decline in overall cognitive status than patients who underwent GPI DBS (p = 0.006). Postoperative cognitive decline was associated with a more medial electrode position only for patients who underwent STN DBS.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Cognitive change was observed in some patients with PD who underwent both GPI and STN DBS, likely due partly to underlying disease progression. Compared with GPI DBS, STN DBS was associated with a greater likelihood of cognitive decline. In STN but not GPI DBS, cognitive decline was associated with medialized electrode position, suggesting modulation of nonmotor STN divisions may contribute to cognitive changes following STN DBS.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.11.jns232164","type":"journal-article","created":{"date-parts":[[2024,2,10]],"date-time":"2024-02-10T01:21:36Z","timestamp":1707528096000},"page":"230-240","source":"Crossref","is-referenced-by-count":11,"title":["Electrode position and cognitive outcome following deep brain stimulation surgery"],"prefix":"10.3171","volume":"141","author":[{"given":"Jeffrey W.","family":"Chen","sequence":"first","affiliation":[{"name":"Vanderbilt University, School of Medicine, Nashville, Tennessee;"},{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Zargari","sequence":"additional","affiliation":[{"name":"Vanderbilt University, School of Medicine, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Cole","sequence":"additional","affiliation":[{"name":"Vanderbilt University, School of Medicine, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishabh","family":"Gupta","sequence":"additional","affiliation":[{"name":"University of Minnesota\u2013Twin Cities Medical School, Minneapolis, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deeptha","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit M.","family":"Dawant","sequence":"additional","affiliation":[{"name":"Departments of Electrical and Computer Engineering and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Departments of Electrical and Computer Engineering and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter E.","family":"Konrad","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario J.","family":"Englot","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Biomedical Engineering, Vanderbilt University, Nashville, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaltra","family":"Dhima","sequence":"additional","affiliation":[{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah K.","family":"Bick","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Biomedical Engineering, Vanderbilt University, Nashville, Tennessee; and"},{"name":"Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"9","key":"b1","series-title":"N Engl J Med","first-page":"896","article-title":"A randomized trial of deep-brain stimulation for Parkinson\u2019s disease","volume":"355","author":"Deuschl G","year":"2006","unstructured":"Deuschl G, Schade-Brittinger C, Krack P,  A randomized trial of deep-brain stimulation for Parkinson\u2019s disease. N Engl J Med. 2006;355(9):896\u2013908."},{"issue":"1","key":"b2","series-title":"JAMA","first-page":"63","article-title":"Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial","volume":"301","author":"Weaver FM","year":"2009","unstructured":"Weaver FM, Follett K, Stern M,  Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301(1):63\u201373."},{"issue":"1-2","key":"b3","series-title":"J Neurol Sci","first-page":"18","article-title":"The epidemiology of dementia associated with Parkinson disease","volume":"289","author":"Aarsland D","year":"2010","unstructured":"Aarsland D, Kurz MW. The epidemiology of dementia associated with Parkinson disease. J Neurol Sci. 2010;289(1-2):18\u201322."},{"issue":"5","key":"b4","series-title":"Ann Neurol","first-page":"586","article-title":"Cognition and mood in Parkinson\u2019s disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: the COMPARE trial","volume":"65","author":"Okun MS","year":"2009","unstructured":"Okun MS, Fernandez HH, Wu SS,  Cognition and mood in Parkinson\u2019s disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: the COMPARE trial. Ann Neurol. 2009;65(5):586\u2013595."},{"issue":"1","key":"b5","series-title":"Lancet Neurol","first-page":"37","article-title":"Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson\u2019s disease (NSTAPS study): a randomised controlled trial","volume":"12","author":"Odekerken VJJ","year":"2013","unstructured":"Odekerken VJJ, van Laar T, Staal MJ,  Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson\u2019s disease (NSTAPS study): a randomised controlled trial. Lancet Neurol. 2013;12(1):37\u201344."},{"issue":"6","key":"b6","series-title":"PLoS One","first-page":"e0156721","article-title":"Cognitive and psychiatric effects of STN versus GPi deep brain stimulation in Parkinson\u2019s disease: a meta-analysis of randomized controlled trials","volume":"11","author":"Wang JW","year":"2016","unstructured":"Wang JW, Zhang YQ, Zhang XH, Wang YP, Li JP, Li YJ. Cognitive and psychiatric effects of STN versus GPi deep brain stimulation in Parkinson\u2019s disease: a meta-analysis of randomized controlled trials. PLoS One. 2016;11(6):e0156721."},{"issue":"22","key":"b7","series-title":"N Engl J Med","first-page":"2077","article-title":"Pallidal versus subthalamic deep-brain stimulation for Parkinson\u2019s disease","volume":"362","author":"Follett KA","year":"2010","unstructured":"Follett KA, Weaver FM, Stern M,  Pallidal versus subthalamic deep-brain stimulation for Parkinson\u2019s disease. N Engl J Med. 2010;362(22):2077\u20132091."},{"issue":"3","key":"b8","series-title":"Neurology","first-page":"411","article-title":"Neuropsychological changes between \"off\" and \"on\" STN or GPi stimulation in Parkinson\u2019s disease","volume":"55","author":"Pillon B","year":"2000","unstructured":"Pillon B, Ardouin C, Damier P,  Neuropsychological changes between \"off\" and \"on\" STN or GPi stimulation in Parkinson\u2019s disease. Neurology. 2000;55(3):411\u2013418."},{"issue":"2","key":"b9","series-title":"Mov Disord","first-page":"172","article-title":"The pallidosubthalamic projection: an anatomical substrate for nonmotor functions of the subthalamic nucleus in primates","volume":"20","author":"Karachi C","year":"2005","unstructured":"Karachi C, Yelnik J, Tand\u00e9 D, Tremblay L, Hirsch EC, Fran\u00e7ois C. The pallidosubthalamic projection: an anatomical substrate for nonmotor functions of the subthalamic nucleus in primates. Mov Disord. 2005;20(2):172\u2013180."},{"issue":"25","key":"b10","series-title":"Proc Natl Acad Sci U S A","first-page":"10661","article-title":"Stimulation of subterritories of the subthalamic nucleus reveals its role in the integration of the emotional and motor aspects of behavior","volume":"104","author":"Mallet L","year":"2007","unstructured":"Mallet L, Sch\u00fcpbach M, N\u2019Diaye K,  Stimulation of subterritories of the subthalamic nucleus reveals its role in the integration of the emotional and motor aspects of behavior. Proc Natl Acad Sci U S A. 2007;104(25):10661\u201310666."},{"issue":"3","key":"b11","series-title":"Ann Clin Transl Neurol","first-page":"613","article-title":"Deep brain stimulation effects on verbal fluency dissociated by target and active contact location","volume":"8","author":"John KD","year":"2021","unstructured":"John KD, Wylie SA, Dawant BM,  Deep brain stimulation effects on verbal fluency dissociated by target and active contact location. Ann Clin Transl Neurol. 2021;8(3):613\u2013622."},{"issue":"1-2","key":"b12","series-title":"J Neurol Sci","first-page":"159","article-title":"Relationship between neuropsychological outcome and DBS surgical trajectory and electrode location","volume":"287","author":"York MK","year":"2009","unstructured":"York MK, Wilde EA, Simpson R, Jankovic J. Relationship between neuropsychological outcome and DBS surgical trajectory and electrode location. J Neurol Sci. 2009;287(1-2):159\u2013171."},{"issue":"3","key":"b13","series-title":"Mov Disord Clin Pract (Hoboken)","first-page":"343","article-title":"Levodopa equivalent dose conversion factors: an updated proposal including opicapone and safinamide","volume":"7","author":"Schade S","year":"2020","unstructured":"Schade S, Mollenhauer B, Trenkwalder C. Levodopa equivalent dose conversion factors: an updated proposal including opicapone and safinamide. Mov Disord Clin Pract (Hoboken). 2020;7(3):343\u2013345."},{"issue":"3","key":"b14","series-title":"Med Image Anal","first-page":"744","article-title":"CranialVault and its CRAVE tools: a clinical computer assistance system for deep brain stimulation (DBS) therapy","volume":"16","author":"D\u2019Haese PF","year":"2012","unstructured":"D\u2019Haese PF, Pallavaram S, Li R,  CranialVault and its CRAVE tools: a clinical computer assistance system for deep brain stimulation (DBS) therapy. Med Image Anal. 2012;16(3):744\u2013753."},{"issue":"6","key":"b15","series-title":"J Neurol Neurosurg Psychiatry","first-page":"622","article-title":"Neuropsychological changes following deep brain stimulation surgery for Parkinson\u2019s disease: comparisons of treatment at pallidal and subthalamic targets versus best medical therapy","volume":"86","author":"Rothlind JC","year":"2015","unstructured":"Rothlind JC, York MK, Carlson K,  Neuropsychological changes following deep brain stimulation surgery for Parkinson\u2019s disease: comparisons of treatment at pallidal and subthalamic targets versus best medical therapy. J Neurol Neurosurg Psychiatry. 2015;86(6):622\u2013629."},{"issue":"4","key":"b16","series-title":"Neuropsychol Rev","first-page":"439","article-title":"Cognition and depression following deep brain stimulation of the subthalamic nucleus and globus pallidus pars internus in Parkinson\u2019s disease: a meta-analysis","volume":"25","author":"Combs HL","year":"2015","unstructured":"Combs HL, Folley BS, Berry DTR,  Cognition and depression following deep brain stimulation of the subthalamic nucleus and globus pallidus pars internus in Parkinson\u2019s disease: a meta-analysis. Neuropsychol Rev. 2015;25(4):439\u2013454."},{"issue":"Pt 10","key":"b17","series-title":"Brain","first-page":"2240","article-title":"Bilateral deep brain stimulation in Parkinson\u2019s disease: a multicentre study with 4 years follow-up","volume":"128","author":"Rodriguez-Oroz MC","year":"2005","unstructured":"Rodriguez-Oroz MC, Obeso JA, Lang AE,  Bilateral deep brain stimulation in Parkinson\u2019s disease: a multicentre study with 4 years follow-up. Brain. 2005;128(Pt 10):2240-2249."},{"issue":"6","key":"b18","series-title":"Stereotact Funct Neurosurg","first-page":"337","article-title":"Deep brain stimulation parameters associated with neuropsychological changes in subthalamic nucleus stimulation for refractory Parkinson\u2019s disease","volume":"86","author":"Schoenberg MR","year":"2008","unstructured":"Schoenberg MR, Mash KM, Bharucha KJ, Francel PC, Scott JG. Deep brain stimulation parameters associated with neuropsychological changes in subthalamic nucleus stimulation for refractory Parkinson\u2019s disease. Stereotact Funct Neurosurg. 2008;86(6):337\u2013344."},{"issue":"3","key":"b19","series-title":"Mov Disord","first-page":"433","article-title":"Neuropsychological outcomes from constant current deep brain stimulation for Parkinson\u2019s disease","volume":"32","author":"Tr\u00f6ster AI","year":"2017","unstructured":"Tr\u00f6ster AI, Jankovic J, Tagliati M, Peichel D, Okun MS. Neuropsychological outcomes from constant current deep brain stimulation for Parkinson\u2019s disease. Mov Disord. 2017;32(3):433\u2013440."},{"issue":"5","key":"b20","series-title":"Parkinsonism Relat Disord","first-page":"321","article-title":"Cognitive outcome and reliable change indices two years following bilateral subthalamic nucleus deep brain stimulation","volume":"17","author":"Williams AE","year":"2011","unstructured":"Williams AE, Arzola GM, Strutt AM, Simpson R, Jankovic J, York MK. Cognitive outcome and reliable change indices two years following bilateral subthalamic nucleus deep brain stimulation. Parkinsonism Relat Disord. 2011;17(5):321\u2013327."},{"issue":"4","key":"b21","series-title":"J Clin Neurosci","first-page":"327","article-title":"A longitudinal of Parkinson\u2019s disease: clinical and neuropsychological correlates of dementia","volume":"3","author":"Reid WG","year":"1996","unstructured":"Reid WG, Hely MA, Morris JG,  A longitudinal of Parkinson\u2019s disease: clinical and neuropsychological correlates of dementia. J Clin Neurosci. 1996;3(4):327\u2013333."},{"issue":"10","key":"b22","series-title":"Parkinsonism Relat Disord","first-page":"1219","article-title":"Mild cognitive impairment in newly diagnosed Parkinson\u2019s disease: a longitudinal prospective study","volume":"21","author":"Santangelo G","year":"2015","unstructured":"Santangelo G, Vitale C, Picillo M,  Mild cognitive impairment in newly diagnosed Parkinson\u2019s disease: a longitudinal prospective study. Parkinsonism Relat Disord. 2015;21(10):1219\u20131226."},{"issue":"4","key":"b23","series-title":"Neurology","first-page":"e384","article-title":"Dementia and subthalamic deep brain stimulation in Parkinson disease: a long-term overview","volume":"95","author":"Bove F","year":"2020","unstructured":"Bove F, Fraix V, Cavallieri F,  Dementia and subthalamic deep brain stimulation in Parkinson disease: a long-term overview. Neurology. 2020;95(4):e384\u2013e392."},{"issue":"6","key":"b24","series-title":"J Neurol","first-page":"1090","article-title":"Long-term cognitive outcome of bilateral subthalamic deep brain stimulation in Parkinson\u2019s disease","volume":"261","author":"Kim HJ","year":"2014","unstructured":"Kim HJ, Jeon BS, Paek SH,  Long-term cognitive outcome of bilateral subthalamic deep brain stimulation in Parkinson\u2019s disease. J Neurol. 2014;261(6):1090\u20131096."},{"key":"b25","series-title":"Clin Neurol Neurosurg","first-page":"87","article-title":"The impact of white matter lesions on the cognitive outcome of subthalamic nucleus deep brain stimulation in Parkinson\u2019s disease","volume":"159","author":"Blume J","year":"2017","unstructured":"Blume J, Lange M, Rothenfusser E,  The impact of white matter lesions on the cognitive outcome of subthalamic nucleus deep brain stimulation in Parkinson\u2019s disease. Clin Neurol Neurosurg. 2017;159:87\u201392."},{"issue":"7","key":"b26","series-title":"Mov Disord","first-page":"974","article-title":"Long-term cognitive profile and incidence of dementia after STN-DBS in Parkinson\u2019s disease","volume":"22","author":"Aybek S","year":"2007","unstructured":"Aybek S, Gronchi-Perrin A, Berney A,  Long-term cognitive profile and incidence of dementia after STN-DBS in Parkinson\u2019s disease. Mov Disord. 2007;22(7):974\u2013981."},{"issue":"11","key":"b27","series-title":"Mov Disord","first-page":"1583","article-title":"Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson\u2019s disease","volume":"25","author":"Daniels C","year":"2010","unstructured":"Daniels C, Krack P, Volkmann J,  Risk factors for executive dysfunction after subthalamic nucleus stimulation in Parkinson\u2019s disease. Mov Disord. 2010;25(11):1583\u20131589."},{"issue":"1-2","key":"b28","series-title":"J Neurol Sci","first-page":"19","article-title":"The effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) on cognition in Parkinson disease","volume":"273","author":"Heo JH","year":"2008","unstructured":"Heo JH, Lee KM, Paek SH,  The effects of bilateral subthalamic nucleus deep brain stimulation (STN DBS) on cognition in Parkinson disease. J Neurol Sci. 2008;273(1-2):19\u201324."},{"issue":"7","key":"b29","series-title":"J Neurol Neurosurg Psychiatry","first-page":"754","article-title":"Predictors of cognitive and psychosocial outcome after STN DBS in Parkinson\u2019s disease","volume":"82","author":"Smeding HMM","year":"2011","unstructured":"Smeding HMM, Speelman JD, Huizenga HM, Schuurman PR, Schmand B. Predictors of cognitive and psychosocial outcome after STN DBS in Parkinson\u2019s disease. J Neurol Neurosurg Psychiatry. 2011;82(7):754\u2013760."},{"issue":"Pt 3","key":"b30","series-title":"Brain","first-page":"746","article-title":"Reversing cognitive-motor impairments in Parkinson\u2019s disease patients using a computational modelling approach to deep brain stimulation programming","volume":"133","author":"Frankemolle AMM","year":"2010","unstructured":"Frankemolle AMM, Wu J, Noecker AM,  Reversing cognitive-motor impairments in Parkinson\u2019s disease patients using a computational modelling approach to deep brain stimulation programming. Brain. 2010;133(Pt 3):746-761."},{"issue":"11","key":"b31","series-title":"Brain","first-page":"3592","article-title":"Non-motor outcomes depend on location of neurostimulation in Parkinson\u2019s disease","volume":"142","author":"Petry-Schmelzer JN","year":"2019","unstructured":"Petry-Schmelzer JN, Krause M, Dembek TA,  Non-motor outcomes depend on location of neurostimulation in Parkinson\u2019s disease. Brain. 2019;142(11):3592\u20133604."},{"issue":"15","key":"b32","series-title":"Neurology","first-page":"1352","article-title":"Optimal target localization for subthalamic stimulation in patients with Parkinson disease","volume":"82","author":"Welter ML","year":"2014","unstructured":"Welter ML, Sch\u00fcpbach M, Czernecki V,  Optimal target localization for subthalamic stimulation in patients with Parkinson disease. Neurology. 2014;82(15):1352\u20131361."},{"issue":"1","key":"b33","series-title":"Transl Psychiatry","first-page":"213","article-title":"Depression history modulates effects of subthalamic nucleus topography on neuropsychological outcomes of deep brain stimulation for Parkinson\u2019s disease","volume":"12","author":"Kratter IH","year":"2022","unstructured":"Kratter IH, Jorge A, Feyder MT,  Depression history modulates effects of subthalamic nucleus topography on neuropsychological outcomes of deep brain stimulation for Parkinson\u2019s disease. Transl Psychiatry. 2022;12(1):213."},{"issue":"7","key":"b34","series-title":"N Engl J Med","first-page":"610","article-title":"Neurostimulation for Parkinson\u2019s disease with early motor complications","volume":"368","author":"Schuepbach WM","year":"2013","unstructured":"Schuepbach WM, Rau J, Knudsen K,  Neurostimulation for Parkinson\u2019s disease with early motor complications. N Engl J Med. 2013;368(7):610\u2013622."},{"issue":"4","key":"b35","series-title":"Brain Stimul","first-page":"904","article-title":"Non-motor outcomes of subthalamic stimulation in Parkinson\u2019s disease depend on location of active contacts","volume":"11","author":"Dafsari HS","year":"2018","unstructured":"Dafsari HS, Petry-Schmelzer JN, Ray-Chaudhuri K,  Non-motor outcomes of subthalamic stimulation in Parkinson\u2019s disease depend on location of active contacts. Brain Stimul. 2018;11(4):904\u2013912."},{"issue":"6","key":"b36","series-title":"Brain Sci","first-page":"755","article-title":"Correlation between electrode location and anxiety depression of subthalamic nucleus deep brain stimulation in Parkinson\u2019s disease","volume":"12","author":"Zhang F","year":"2022","unstructured":"Zhang F, Wang F, Xing YJ,  Correlation between electrode location and anxiety depression of subthalamic nucleus deep brain stimulation in Parkinson\u2019s disease. Brain Sci. 2022;12(6):755."},{"issue":"6","key":"b37","series-title":"Ann Neurol","first-page":"962","article-title":"Left prefrontal connectivity links subthalamic stimulation with depressive symptoms","volume":"87","author":"Irmen F","year":"2020","unstructured":"Irmen F, Horn A, Mosley P,  Left prefrontal connectivity links subthalamic stimulation with depressive symptoms. Ann Neurol. 2020;87(6):962\u2013975."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/141\/1\/article-p230.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/141\/1\/article-p230.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/141\/1\/article-p230.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T11:47:49Z","timestamp":1732621669000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/141\/1\/article-p230.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,1]]},"references-count":37,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2023.11.jns232164","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,1]]}}}