Abstract Details

Title Influence of Body Mass Index (BMI) and Blood Pressure (BP) on Deep Brain Stimulation (DBS) Outcomes in Parkinson’s disease (PD) Patients

Topic Movement Disorders

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-003

Objective PD literature supports a complex relationship between preoperative obesity, BP abnormalities, and post-DBS cognitive and motor outcomes. This study aims to improve on evidence associating BMI and BP with cognitive, emotional, and quality-of-life outcomes post-DBS.

Background Previous studies indicate obesity and hypertension increase intra-/ post-operative complications. Up to 65% of PD patients may be overweight or obese, with obese patients having less axial motor improvement and worsened cognitive function six months post-DBS. PD patients have also demonstrated increased BP fluctuations compared to healthy controls.

Design/Methods PD patients [n=28, Mage=62.6(8.8), 75% male, Medu=16.1(3.0), 92.9% STN) underwent pre-/post-DBS assessment (global cognition, language, memory, attention, processing speed, visuospatial ability) and emotional screenings via TeleNP. Systolic (M=130.0; SD=19.5) and diastolic (M=74.4; SD=16.0) BP (SBP, DBP), weight, and height were measured pre-DBS surgery. BMI was computed (M=27.3; SD=6.1). Logistic regression was used to predict neurocognitive performance using BMI, SBP, and DBP.

Results

BMI, SBP, and DBP predicted decline in verbal reasoning in post-, compared to pre-, DBS testing, but not other assessed domains. Model coefficient estimates of 0.40 [p=.02, OR=1.5 (95% CI [1.07, 2.10])] for BMI, 0.13 [p=.04, OR=1.13 (95% CI [1.01, 1.28])] for SBP, and -0.15 [p=.08, OR=0.86 (95% CI [0.73, 1.02])] for DBP were indicated. Model fit was robust [X²(3)=14.2, p=.003]. While holding BP constant: each unit increase in BMI predicted a 50% increase in odds of verbal reasoning decline (one-half SD or more), and a unit increase in SBP (or decrease in DBP) predicted a 13% increase in odds (or, respectively, a 14% decrease in odds) of verbal reasoning decline. Post-DBS patient classification using BMI and BP predictors yield a .882 specificity and a .857 sensitivity.

Conclusions BMI, SBP, and DBP should be considered in predicting DBS surgical outcomes, particularly on verbal reasoning tasks. This small sample requires replication but is consistent with existing literature.

Authors/Disclosures
Julia See PRESENTER	Miss See has nothing to disclose.
Scott Harcourt, PhD (Blue Cat Neuropsychology & Intervention, PLLC)	Dr. Harcourt has nothing to disclose.
Annelly Buré-Reyes	Annelly Buré-Reyes has nothing to disclose.
	No disclosure on file
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
Hannah M. Bullock (University of Miami - Miller School of Medicine)	Ms. Bullock 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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