Abstract Details

Title Clinical Utility of Home-to-Home Tele-neuropsychology (TeleNP) in the Assessment of Post-Operative Deep Brain Stimulation (DBS) Outcomes in Parkinson’s disease (PD) Patients

Topic Movement Disorders

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-012

Objective The coronavirus pandemic facilitated widespread implementation of tele-neuropsychological assessment of DBS candidates due to physical distancing and safety requirements. Our prior work has demonstrated preoperative home-to-home TeleNP feasibility and patient satisfaction in determining candidacy for DBS in PD patients. To our knowledge the implementation and feasibility of TeleNP in assessing postoperative outcomes have not been assessed.

Background

Neurologists work closely with neuropsychologists who evaluate postoperative cognitive, behavioral, and mood outcomes in PD patients. For PD patients with barriers to accessing care, home-to-home TeleNP post-DBS management provides a much-needed resource to increase care access.

Design/Methods PD patients [n=28, M_age=62.6(8.8), 75% male, M_edu=16.1(3.0), 46.4% Hispanic, 64.3% pretested in English/35.7% in Spanish, 92.9% STN), underwent pre- and post-cognitive (global cognition, language, memory, attention, processing speed, visuospatial ability) and emotional assessments via home-to-home TeleNP between May 2020 and March 2022. PD patients underwent either in-person (n=23) or TeleNP (n=5) evaluation pre-DBS and in-person (n=1) or home-to-home TeleNP (n=27) assessments post-surgery. Paired t-tests were conducted to assess differences between pre and post assessments.

Results To date, 28 candidates completed both pre- and post-DBS neuropsychological assessment. Significant differences in semantic fluency (Animals: t(53)=3.89, d=.53, m_z-d_iff=0.6), short- and long-delay verbal recall (CVLT: t(43)=2.95, d=.44, m_z-d_iff=0.4 and t(47)=3.13, d=.45, m_z-d_iff=0.4 respectively), and processing speed (SDMT: t(23)=3.57, d=.73, m_z-d_iff=0.8) were noted at p<.005 (Bonferroni-adjusted for family-wise error), where m_z-d_iffrepresents z-score decrease from pre- to post-test. In contrast, no significant change was noted in orientation, naming, phonemic fluency, working memory, executive functioning, verbal reasoning, depression, anxiety, or PD symptom dysfunction (PDQ-39).

Conclusions TeleNP is a feasible platform for comprehensively assessing short- and long-term outcomes in PD patients post-DBS in English and Spanish. Remote care reduces the risk of patients being lost to follow-up by offering time- and cost advantages to those who have physical or transportation limitations or are living in remote areas.

Authors/Disclosures
Hannah M. Bullock (University of Miami - Miller School of Medicine) PRESENTER	Ms. Bullock has nothing to disclose.
Scott Harcourt, PhD (Blue Cat Neuropsychology & Intervention, PLLC)	Dr. Harcourt has nothing to disclose.
	No disclosure on file
Annelly Buré-Reyes	Annelly Buré-Reyes has nothing to disclose.
Corneliu C. Luca, MD (University of Miami)	Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Luca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Signant Health. Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott.
Jonathan Jagid	Jonathan Jagid has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Miami Dade County State Attorneys office. The institution of Jonathan Jagid has received research support from Boston Scientific.
Bonnie E. Levin, PhD	No disclosure on file
Julia See	Miss See has nothing to disclose.
Ihtsham Haq, MD, FAAN (University of Miami Miller School of Medicine)	The institution of Dr. Haq has received research support from NINDS. The institution of Dr. Haq has received research support from the Parkinson's Foundation.
Marina Sarno, Other (University of Miami Department of Neurology)	Dr. Sarno has nothing to disclose.

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