The COVID-19 pandemic created unique challenges for neuropsychological assessment of DBS candidates due to physical distancing and safety requirements. Existing literature has demonstrated guidelines and feasibility of neuropsychological measures administered via teleconference, but none to our knowledge have assessed implementation, feasibility, clinical utility, and acceptance of home-to-home TeleNP in determining candidacy for DBS in Parkinson’s disease (PD) patients.

PD is the second most common neurodegenerative disorder and DBS surgery offers significant improvement in motor symptoms and quality of life for medication refractory patients. Since neuropsychologists play an essential role in evaluating cognitive and behavioral changes that impact decisions on DBS surgical candidacy, adapting current practices is critical for continuity of care.

PD patients [n=72, M_age=63.3(8.76), 65.3% male, M_edu=14.7(2.93), 50.7% Hispanic, 58.3% tested in English/41.7% in Spanish) underwent neuropsychological (global cognition, language, memory, attention, processing speed, visuospatial ability) and emotional assessments via home-to-home TeleNP between May 2020 and August 2021. Independent t-tests were conducted to assess TeleNP discriminability of cognitive and emotional function in surgical candidates.

To date, 66 candidates were approved for DBS (44 completed surgery, 17 are pending, 5 opted not to proceed), and 6 were not surgical candidates due to neurocognitive and/or severe psychiatric disorders. Surgical candidate mean neuropsychological scores were average across all domains, with normal to mild mood symptoms. The non-selected group differed by education but not age, and was significantly different (p<.006) in overall cognition [MoCA t(70)=3.62], working memory [WAIS-IV DS t(70)=3.15], phonemic fluency [COWAT FAS t(70)=2.85], verbal reasoning [WAIS-IV SI t(67)=3.38], perceptual reasoning [WAIS-IV MR t(70)=3.02], depression [BDI-2 t(68)=3.47], and anxiety [BAI t(70)=2.88].

TeleNP is a successful platform for assessing DBS surgical candidacy safely in English and Spanish speaking PD patients and offers potential for providing high quality screening for those with physical limitations, reduced access to transportation, or are living in remote areas.